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Objective To investigate the effect of multiple treatments on cystospasm after transurethral resection of prostate(TURP). Methods From 2006 to 2013, 663 patients who had received TURP for BPH were civided into 6 groups:2 were treated by kieselgel or lac-toprene urethral catheter,defined as catheter observe group. 2 were treated by warmed or ordinary temperature douche,defined as temperature observe group. 2 were treated by dicaine mixed or normal douche,defined as mixed douche observe group. The incidence rates and duration of cystospasm and visual analogue scores of pain were observed and the diversities were measured by statistics within each pair groups. Results The incidence rates and duration of cystospasm and visual analogue scores of pain of groups treated by kieselgel urethral catheter,warmed douche and dicaine mixed douche were obviously lower than the groups treated by lactoprene urethral catheter,ordinary temperature douche and normal douche. The kieselgel urethral catheter and warmed douche decreasing the irritation on mucous membrane of bladder,the dicaine decreasing the sensibility of bladder nerves may be the mechanism. Conclusion The incidence rates and duration of cystospasm and visual analogue scores of pain can be obviously decreased by treatments of kieselgel urethral catheter,warmed douche and dicaine mixed douche.
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Objective To investigate the correlation between hemorrhage in transurethral resection of prostate ( TURP) and cystospasm and psychonosema of the patients with hyperplasia of prostate. Methods All clinic data of 322 patients with hyperplasia of prostate who have had TURP from 2009 to 2013 were reviewed. These patients were divided into four groups according to the volume of hemorrhage( H):H<400 mL, 400≤H<600 mL, 600≤H<800 mL, H≥800 mL. The quantity of cystospasm and psychonosema was measured by three catego-ries:no symptom, light symptom without treatment, severe symptom with treatment. The differences of the four groups were compared through statistical methods. Results The incidence rates of cystopasm and severity degree of psychonosema were increased with the raise of hemorrhage . Conclusion There is a positive correlation between the incidence rates of cystopasm and psychonosema and the volume of hem-orrhage in the patients with hyperplasia of prostate who have had TURP.
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Objective To investigate the effect of indwelling double-J ureteral stents before flexible ureteroscope lithotrity in terms of operation time, postoperative hospitalization time and operation effect. Methods All clinical data of flexible ureteroscope lithotrity from 2009 to 2013 were reviewed. Operation time, postoperative hospitalization time and recurrence rate of calculus of patients who received operation directly and patients who received indwelling of double-J ureteral stents 2 weeks before operation were observed and compared. Results Op-eration time, postoperative hospitalization time, and recurrence rate of calculus of patients who received indwelling of double-J ureteral stents 2 weeks before receiving operation were obviously lower than patients who received operation directly. Conclusion Operation time, postoper-ative hospitalization time and recurrence rate of calculus can be decreased by indwelling double-J ureteral stents 2 weeks before operation.
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Objective To evaluate the efficacy and safety of retroperitoneal laparoscopic pyelolithotomy ( RLP) combined with holmium laser lithotripsy under flexible cystoscopy in the treatment of complicated nephrolithiasis. Methods The retrospective analysis was made on the clinical data of 37 patients who underwent RLP and holmium laser lithotripsy under flexible cystoscopy for complicated nephrolithiasis from January 2013 to January 2014. The clinic parameters involved basic data of patients,operational time,blood loss,post-operative hospital stay,the status of stone-free,perioperative complications,and the follow-up data of patients were observed. Results No patient was converted to open surgery. The mean stone size was (2. 8 ± 0. 9) cm in diameter,operational time was (89 ± 24) min,blood loss was (21. 3 ± 7. 7) mL,post-operative hospital stay was (6. 8 ± 1. 7) d,the stone removal rate in one session was 94. 6%. One case occurred urinary leakage,1 case occurred fever after operation,who were all recovered through conservative treatment. All cases were followed up at the sixth months after operation. Conclusion RLP combined with holmium laser lithotripsy under flexible cystoscopy is effective and safe for the treatment of com-plicated nephrolithiasis.
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Objective To investigate the key points for management of subclinical and agonal types of penetrating cardiac trauma (PCT).Methods A retrospective analysis was conducted on clinical data of 135 PCT cases treated from January 2005 to March 2012.The cases were divided into subclinical type,clinical type (cardiac tamponade or hemorrhagic shock types) and agonal type.Managements of the two extreme types including subclinical type and agonal type were studied in groups.Results (1) Thirty cases of subclinical type failed to have timely diagnosis and treatment due to the withdrawal from inhospital observation,which resulted in 22 deaths.Eleven cases of subclinical type had timely diagnosis through in-hospital observation or cardiac exploration,but three cases died in operating room thoracotomy (ORT).There were 27 cases of agonal type,but 15 died in ORT and two died in emergency room thoracotomy (ERT).Of 67 cases of clinical type,seven died in ORT.(2) A total of 86 cases survived ORT or ERT after timely diagnosis or diagnosis through in-hospital observation plus cardiac exploration.In the meantime,sound recovery was observed in 3-24 months of follow-up.Conclusion Success rate in treatment of PCT can be enhanced by close observation and timely cardiac exploration for subclinical type PCT and by timely ERT and bleeding control for agonal type PCT.
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ObjectiveTo explore the feasibility of mediating recipient lymphocyte reaction with donor dendritic cells (DCs) in renal allograft recipients to guide individualized inmunosuppressive therapy. Methods From Jan. 2008 to Jan. 2010, 30 recipients received living related kidney transplantation were successively and divided into 2 groups according to the strategies of the correction of the dosage of immunosuppressant, 15 in each group. The strategy of immunosuppressive therapy in both groups was Tac + MMF + Pred. The correction of the dosage of immunosuppressant in experimental group was conducted by recipient lymphocyte reaction with donor DC (LR) combined with Tac and MPA blood concentration monitoring. Only blood concentration monitoring of drugs was applied in control group. Examinations of liver and renal function, blood and urine routine as well as blood sugar were done monthly for 1 year. ResultsDuring the follow-up period, the rate of acute rejection in experimental group and control group was 13. 3 ％ and 46. 7 ％ respectively (P＜0. 05) ;the rate of infection in experimental group and control group was 6. 7％ and 40. 0％ (P＜0. 05)respectively; the adverse reaction rate in experimental group and control group was 13. 3％ and 46. 7％(P＜0. 05). There was no significant difference in the serum creatinine level between the two groups at each observation point. ConclusionThe application of combined recipient LR with donor DC and blood concentration monitoring of drugs in individualized irnmunosuppressive therapy is more comprehensive and accurate.
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Objective To explore the feasibility of mediating recipient lymphocyte reaction with donor dendritic cells (DCs) in renal allograft recipients. Methods Donor bone marrow monocytes (BMMCs) were isolated and cryopreserved in liquid nitrogen before kidney transplantation. At 0 day, 1month,3 month, 6 month and 9 month post-operation, CD34+ cells which were isolated from frozen BMMCs and cultured into DCs as well as the peripheral blood lymphocytes (PBLs) of donors were used as the stimulating cells to the PBLs of recipients and healthy volunteers. The number of viable DCs from frozen- and room temperature-preserved BMMCs was counted and the reactions of recipients'and healthy volunteers' lymphocytes to DCs and donor PBLs were measured. Results 6. 8 × 107BMMCs were isolated from each 10 ml of donor bone marrow on average while (4. 10 ± 0. 58) × 105CD34+ cells were isolated by magnetic active cell sorting (MACS). There was no significant difference in the isolating rate of recovered CD34+ cells at each observation point postoperatively. The percentage of viable BMMCs and CD34+ was decreased significantly at 1 month after surgery, then, decreased slowly and progressively. The decreasing rate of BMMCs was higher than CD34+. The rate of viable DCs was maintained stable (93. 2%-94. 8% ) in each group. The reactions of recipients' and healthy volunteers' lymphocytes to DCs were stronger than those to donor PBLs (P＜0. 05). The reactions of healthy volunteers' lymphocytes to DCs were maintained stable while those of recipients' were fluctuating. Conclusion Bone marrow-derived DCs are superior to PBLs in mediating long-term lymphocyte reaction after kidney transplantation due to their stable viability and stimulating ability to lymphocytes. Only once collection of a small quality of bone marrow of donors is needed to meet the demand of immune monitoring at any time after transplantation.
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OBJECTIVE:To investigate the effects of long-term use of calcium channel blocker-Diltiazem(Dil)on the dosage of ciclosporin A and renal function of renal graft recipients.METHODS:Dil was administed in67renal graft recipi?ents,meanwhile who were orally taking CsA with another59renal graft recipients served as controls.The dosages of ci?closporin A of2group were adjusted to the level within therapeutic window,then the dosage of CsA and serum creatinine change of the2groups36mo after drug administration were observed.RESULTS:12mo,24mo and36mo after operation,the synchronized cyclosporin A dosages in Dil group were lower than the control group respectively by14353mg,9656mg and7817mg.No significant differences were found in serum creatinine levels between the2groups within the first12mo after operation.Thereafter,the creatinine levels in the control group has a faster increase and the creatinine level in Dil group was significantly lower than that of the control group18mo～36mo after operation(P
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<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of sildenafil citrate in man kidney transplant recipients with erectile dysfunction.</p><p><b>METHODS</b>One hundred and seventy married males, aged 26 approximately 50 years, who had received kidney transplantations at least half a year before and whose serum creatinine was under 133 umol/l, were selected randomly in the study. Their sexual function was investigated according to the International Index of Erectile Function-5 (IIEF-5), and those with erectile dysfunction (ED) were treated with oral sildenafil citrate for 6 months. The efficacy was assessed by IIEF-5.</p><p><b>RESULTS</b>Fifty-three men with ED received oral sildenafil citrate for 6 months. At the end of the treatment, each index in IIEF-5 increased significantly. There were no interactions between sildenafil and cyclosporine and there was no significant adverse effect of sildenafil on the graft function.</p><p><b>CONCLUSION</b>Sildenafil is an effective and safe agent for the treatment of ED in kidney transplant recipients.</p>
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Adult , Humans , Male , Middle Aged , Erectile Dysfunction , Drug Therapy , Kidney Transplantation , Piperazines , Therapeutic Uses , Purines , Sildenafil Citrate , SulfonesABSTRACT
Objective:To determine the efficacy of losartan a specific angiotensin Ⅱ receptor antagonist,in improving renal function among renal transplant recipients with chronic allograft nephropathy(CAN).Methods:18 renal transplant recipients with CAN (group Ⅰ)were treated with losartan for at least one year.Another 23 patients with CAN (group Ⅱ) while not treated with losartan were used as control in the same period.Renal function,blood and urine TGF-? 1 concentration were compared between the two groups.Results:One year later,there were 12 patients (67.0%) with stabilized or improved graft function in group Ⅰ,and 4 patients (17.0%) in group Ⅱ.The difference was significant.Blood and urine TGF-? 1 concentration and renal function lost were lower m group Ⅰ than in group Ⅱ.No side effects were noted in all patients in group Ⅰ.Conclusion:Losartan can improve renal fimction among renal transplant recipients with chronic allograft nephropathy through reducing TGF-? 1 secretion in the kidney.
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Nowadays,in order to cultivate a great number of high-quality clinicians,on students it is essential for medical university to strengthen education of humanities,excite aspiration for innovating,cultivate innovation ability and teach the modern medical knowledge with science and rational method.The author has given his reasons and made suggestions for the opinion in the article.
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Objective To observe the protective effects of enalapril on the long-term functions of the allograft in renal transplant recipients. Methods Twenty renal transplant recipients with ~survival time over one year, normal renal functions of the allograft and urine TGF-?_1 levels being more than ~250.0 pg/mg.Cr took enalapril every day for at least one year. Twenty-three recipients under the same conditions who did not receive enalapril served as control group. Three years later renal ~dysfunction cases, loss of creatinine clearance rate (Ccr) and TGF-?_1 levels in blood and urine were compared between the two groups. The changes in the expression of TGF-?_1mRNA in renal biopsy specimens were compared before and one year after enalapril therapy. Side-effects of enalapril were ~investigated in all patients in enalapril-treated group. Results Three years later, the number of renal dysfunction cases was less, the loss of Ccr was less and the level of urine TGF-?_1 was lower in ~enalapril -reated group than those in control group with the differences being significant (P~0.05 ). One year after enalapril therapy TGF-?_1mRNA expression was significantly decreased in renal biopsy specimens (P
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Objective To investigate whether reduced or discontinued calcineurin inhibitor (CNI) can improve the renal functions of renal transplant recipients with chronic allograft nephropathy (CAN). Methods A total of 46 renal transplant recipients with declining graft function and biopsy proven CAN were studied. Within 1～2 weeks, CNI (Cyclosporine A or Tacrolimus ) in 27 recipients (group A) was discontinued or reduced to one third of their original doses, but Azathioprine (Aza) or mycophenolate mofetil (MMF) was increased properly. The doses of CNI in the 19 recipients (group B) were not changed obviously, but Aza or MMF was increased properly. At least 1-year follow-up was performed in all patients. Renal functions were compared between the two groups. The incidence of acute renal graft rejection was calculated in both groups. Results One year later, there were 17 patients (63.0%) with stabilized or improved graft function in group A, and 2 (10.5%) in group B. The difference was significant. The incidences of acute rejection in both groups were not significantly different. Conclusion For some renal transplant recipients with declining graft function and biopsy proven CAN, remarkably reduced or discontinued CNI can stabilize or improve their renal functions. Adjusting the doses of immunosuppressive agents does not increase the risk of acute rejection.
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Objective To observe the efficacy of local gene transfection in CD154 extracellular domain on the survival of renal allografts. Methods The kidneys of Brown Norway (BN) rats were transfected with CD154 extracellular domain gene recombined adenovirus. The transfected kidneys were transplanted to Lewis rats (transfection group). BN→Lewis kidney transplantation with non transplanted kidneys served as the controls. The allograft survival time and the allograft function between the two groups were compared. Results The allograft survival time of the transfection group was longer than that of the controls significantly [(28?7.3)d vs (8.6?1.2) d, P
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Objective To investigate whether cytomegalovirus (CMV) infection is associated with chronic allograft nephropathy (CAN). Methods 131 patients underwent kidney transplantation from August 1, 1999 to November 30, 2000 were enrolled in this study. CMV-pp65 antigen load (the number of CMV-pp65-positive leukocytes) in peripheral blood within 6 months of posttransplant was detected, and TGF-? 1 mRNA expression in renal allograft biopsy was measured at the 7th month after transplant. The renal functions of the patients were followed up at least three years. Results The TGF-? 1 mRNA level in allografts of the patients with long-time and high-level CMV-pp65 antigen load was obviously higher that that of the patients without. 3 years after transplant, there were lower Ccr and more renal dysfunction in the patients with long-time and high-level CMV-pp65 antigen load than in the patients without, the difference of which was significant between the two groups of patients. Conclusion Serious CMV infection with long duration can damage the function of kidney graft, and is a risk factor for renal dysfunction.
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Objective To investigate the protective effect of calcium antagonist Verapamil (VP) on kidney preservation in HCA solution. Methods After kidneys were isolated from rabbits, they were perfused and stored in HCA solution or in HCA solution with VP pre-supplement at 4℃ for 24 h respectively. The contents of mitochondrial calcium in renal cells and ATP in renal tissues were measured in every group. Results The contents of mitochondrial calcium was remarkably higher and ATP significantly lower in the kidneys in HCA solution at 4℃ for 24 h than those just after resection. But these could be inhibited in those storing in the HCA solution with VP pre-supplement. Conclusion Calcium antagonist VP can protect kidney function during HCA solution preservation by inhibiting calcium intaking into mitochondrium.
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114 ?mol/L continuously) and loss of creatinine clearance (Ccr) were also compared among the 4 groups.For patients with renal dysfunction,the renal biopsies were used to determine whether they had CAN. Results Seventy-seven patients were followed up for 3 years,and their data were analyzed.There were 15 cases in Group A,32 in Group B,18 in Group C,and 12 in Group D.In Groups A,B and C,the expressions of TGF-? 1 protein in the allografts at 7 months after transplantation were (5.82?1.32)?10 6,(6.34? 1.47 )?10 6 and (6.58?1.44)?10 6,and the expressions of TGF-? 1 mRNA were 0.84?0.17,0.78? 0.15 and 0.82?0.16,respectively.In Group D the expressions of TGF-? 1 protein and mRNA were (10.47? 2.12 )?10 6 and 1.37?0.25,which were significantly greater than those in Groups A,B and C ( P
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Objective To observe the protective role of enalapril as a specific angiotensin converting enzyme inhibitor on allograft in renal transplant recipients.Methods From Jan 2000 to Jun 2001,22 cases of renal transplant recipients with normal renal function and urine TGF-?_1 concentration being higher than 250.0 pg/mg Cr(group A) underwent therapy with angiotensin converting enzyme inhibitor(enalapril) one year after surgery.Enalapril was administered at a dose of 50 mg/d for the patients in group A for at least one year.Twenty-three recipients who never received angiotensin converting enzyme inhibitor in the same condition were studied as Group B.The adverse reactions of enalapril were investigated in group A and the expression of TGF-?_1mRNA in renal grafts were compared between before and 1 year after enalapril therapy.At the end of 3-year study period,the renal function,the decrement of creatinine clearance rate(Ccr) and the concentration of TGF-?_1 in blood and urine were compared between the two groups respectively.Results The Ccr decreased faster in group B than in group A.During three years study period,the decrements of Ccr were(5.1?4.6) and(13.7?9.5)(ml/min) in group A and group B respectively,and there were 2 cases and 9 cases with chronic allograft nephropathy(CAN) respectively.The decrement of Ccr and the number of CAN cases were significant difference between group A and group B(all P
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Objective To investigate the effects of substituting tacrolimus (FK506) for cyclosporine (CsA) on delaying the pace of renal dysfunction in patients with biopsy-proven chronic allograft nephropathy (CAN) and the molecular mechanism of the therapy.Methods From January, 1999 to May, 2002, 93 renal transplant recipients with declining graft function and biopsy-proven CAN (Grade Ⅰ), who had been taking cyclosporine (CsA) as immunosuppressive agent were studied. The patients were randomly divided into group A and group B. CsA was replaced with FK506 (1∶75) in group A that included 50 patients. Group B including the other 43 patients served as control group. All patients were followed up at least three years. Renal functions, losses of creatinine clearance rates within 3 years, incidence of acute renal graft rejection and plasma TGF-?_ 1 concentrations were compared between the two groups.Results Three years later, there were 31 patients ( 62.0 % ) with stabilized or improved graft function in group A, and 4 patients ( 9.3 % ) in group B. The difference was significant (P
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OBJECTIVE:To assess whether Alprostadil plays a role in improving renal function of renal recipi?ents.METHODS:A randomized control clinical trial was designed between January1,2001and February28,2004.Alprostadil was administered in85renal recipients who received60?g Alprostadil while transplanting kidney and each day after opera?tion.The effects of Alprostadil were compared with the control group which included276recipients to determine the influences of Alprostadil on urine,creatinine(Cr)and creatinine clearance(Ccr).Under Doppler Ultrasound the renal blood flow resis?tance_indexes(RI)were measured.The rates of acute renal graft rejection(AR)and delayed graft function(DGF)were also calculated in both groups.RESULTS:Urine and Ccr were significantly higher in Alprostadil_treated group than in control.On the contrary Cr and RI were significantly lower in Alprostadil_treated group than in control.Alprostadil_treated group also showed a significantly lower incidence of DGF,but the incidences of rejection in both groups were equal.CONCLUSION:The findings suggest that the addition of Alprostadil to renal recipients improves early graft function and reduce the incidence of DGF,but does not influence the incidence of rejection.