The advances in the research of noninvasive diagnostic methods for bladder outlet obstruction / 中华泌尿外科杂志

This article reviewed the recent advances in the research of noninvasive diagnostic methods for bladder outlet obstruction. Penile cuff test, detrusor wall thickness, ultrasound-estimated bladder weight and near-spectroscopy showed a promising diagnostic results. However, more rigorous and higher level clinical trials with larger sample size are needed to validate the diagnostic value of these tests.

The abnormalities of free uroflow curve in female patients with detrusor underactivity and their clinical significance / 中华泌尿外科杂志

Objective:To explore the features of free uroflow(FF) curve patterns in female patients with detrusor underactivity(DU) and their clinical significance.Methods:Data of 275 adult female patients with lower urinary tract symptoms(LUTS) underwent urodynamic studies(UDS) at urology center of our hospital from June 2014 to June 2016 were analyzed retrospectively. The uroflow curve patterns of patients with DU were classified and analyzed in the context of parameters of FF, cystometry (CM), and pressure-flow study(PFS). The prevalence of each abnormal uroflow curve pattern in DU patients were calculated and compared with those in non-DU patients.Results:No bell-shaped curve was found in 141 patients with DU. The abnormal curve patterns can be divided into 5 types: Type Ⅰ (bell-shaped curve with saw tooth) in 20 cases (14.2%), Type Ⅱ (box-like curve) in 34 cases (24.1%), Type Ⅲ (triangle curve with decreasing slop) in 62 cases(43.9%), Type Ⅳ (triangle curve with increasing slop) in 4 cases (4.3%), Type Ⅴ (tide-wave curve)in 19 cases (13.5%). Maximum flow rate of free uroflow(Q max.FF) of type Ⅰ [(28.4±9.7) ml/s] was significantly greater than that of type Ⅱ, Ⅲ and Ⅴ[(17.0±4.1), (15.8±5.4) and (12.9±6.4) ml/s, P<0.05]. Flow time of free uroflow(FT.FF) of type Ⅲ and Ⅴ [(43.7±17.2) and (50.1±28.9)s] were significantly longer than that of type Ⅰ and Ⅱ [(18.5±7.3)s and (27.2±9.7)s, P<0.05]. Post voided residual > 50ml was noted in 19 cases (30.6%) of type Ⅲ, 7 cases (36.8%) of type Ⅴ, 1 case (2.9%) of type Ⅱ and no one in type Ⅰ and Ⅳ. Abnormal manifestations in cystometry mainly included bladder hypersensitivity, detrusor overactivity, and stress urinary incontinence. Detrusor pressure at Q max (Pdet.Q max) of type Ⅴ [(7.4±5.0) cmH 2O] was significantly lower than that of type Ⅰ, Ⅱ, Ⅲ [(11.8±6.7), (12.0±5.3), (12.1±5.0) cmH 2O, P<0.05]. Among 134 cases of non-DU, there were type Ⅰ curves in 88 cases (65.7%), type Ⅱ curves in 4 cases (2.9%), type Ⅲ curves in 15 cases (11.2%), type Ⅳ curves in 1 cases (0.7%), type Ⅴ curves in 7 cases (5.2%). And normal bell-shaped curves in 19 cases(14.2%). The prevalence of type Ⅱ, Ⅲ and Ⅴ in DU patients was significantly higher than that in the non DU patients ( P<0.05). Conclusions:This study reveals that the characteristics of reduced detrusor contractility and duration, prolonged bladder emptying or incomplete emptying can be reflected in the patterns of free uroflow curve in female patients with DU. The abnormalities of these free uroflow curve patterns, especially type Ⅱ, Ⅲ and Ⅴ will be helpful in preliminarily screening DU in females.

Safety and efficacy of sacral neuromodulation therapy for lower urinary tract dysfunction in elderly people: A multicenter study / 中华老年医学杂志

Objective:To investigate the safety and efficacy of sacral neuromodulation(SNM)therapy for the treatment of lower urinary tract dysfunction(LUTD)in elderly patients.Methods:Clinical data of 91 elderly patients with LUTD from multiple medical institutions who received SNM during the period from January 2012 to December 2016 were retrospectively analyzed.Patients were divided into four groups: the interstitial cystitis(IC)group(n=28), the neurogenic bladder(NB)group(n=36), the overactive bladder syndrome(OAB)group(n=13)and the idiopathic dysuria(ID)group(n=14). Different sets of evaluation parameters were used for different diseases.Patients’ baseline data and data in stage I(test phase)and stage Ⅱ(permanent SNM)were recorded, statistically analyzed and compared.Results:Ninety-one people underwent SNM treatment.Of them, 53 patients received permanent implants(stage Ⅱ), and the total conversion rate of stage I to stage Ⅱ was 58.2%(53/91). Patients receiving permanent implants(stage Ⅱ)had a preoperative period ranging from 3 months to 30 years, and were followed up for 2 to 58 months after treatment, with an average follow-up of 19.6 months.The improvement rates in stage I for urinary urgency, daily urination frequency, daily nocturnal urination frequency, maximum urine volume, daily average urine volume, daily urine leakage frequency, and quality of life score were 35.4%, 31.6%, 33.7%, 32.6%, 49.2%, 43.2% and 13.2%, respectively.The improvement rates in stage Ⅱ for urinary urgency, daily urination frequency, daily nocturnal urination frequency, maximum urine volume, daily average urine volume, daily urine leakage frequency, and quality of life score were 43.2%, 40.0%, 37.8%, 50.5%, 70.5%, 70.4% and 43.2%, respectively.Three adverse events occurred, including 1 case of recurrent symptoms, 1 case of moderate infection, and 1 case of electrical lead dislocation.Conclusions:Sacral nerve stimulation has definitive and consistent curative effects on LUTD in elderly people.The follow-up time should be extended to further study the safety of sacral nerve stimulation.

Clinical characteristics during the perioperative period of pheochromocytomas in the elderly / 中华老年医学杂志

Objective@#To investigate the clinical characteristics during the perioperative period of pheochromocytoma in patients aged 60 years and over.@*Methods@#Data of age, sex, tumor size, anesthesia time, intraoperative bleeding volume, intraoperative blood pressure, complications and hospitalization time from patients with pheochromocytoma in our hospital treated by the retroperitoneal laparoscopic adrenalectomy from January 2008 to October 2018 were retrospectively analyzed.The relationships of age with the intraoperative hemodynamic instability and postoperative complications were analyzed.@*Results@#A total of 203 patients with pheochromocytoma met the inclusion criteria were enrolled.Age over 60 years(OR1.771, 95%CI=1.015-3.089, P=0.044)was an independent risk factor for intraoperative hemodynamic instability.@*Conclusions@#Laparoscopic retroperitoneal adrenalectomy is a safe surgical method for pheochromocytoma patients aged 60 years and over.For elderly patients with pheochromocytoma, especially those with a tumor diameter of more than 5 cm, special attention should be paid to the prevention of intraoperative hypertension crisis.

Clinical characteristics during the perioperative period of pheochromocytomas in the elderly / 中华老年医学杂志

Objective To investigate the clinical characteristics during the perioperative period of pheochromocytoma in patients aged 60 years and over.Methods Data of age,sex,tumor size,anesthesia time,intraoperative bleeding volume,intraoperative blood pressure,complications and hospitalization time from patients with pheochromocytoma in our hospital treated by the retroperitoneal laparoscopic adrenalectomy from January 2008 to October 2018 were retrospectively analyzed.The relationships of age with the intraoperative hemodynamic instability and postoperative complications were analyzed.Results A total of 203 patients with pheochromocytoma met the inclusion criteria were enrolled.Age over 60 years (OR 1.771,95 ％ CI =1.015-3.089,P =0.044)was an independent risk factor for intraoperative hemodynamic instability.Conclusions Laparoscopic retroperitoneal adrenalectomy is a safe surgical method for pheochromocytoma patients aged 60 years and over.For elderly patients with pheochromocytoma,especially those with a tumor diameter of more than 5 cm,special attention should be paid to the prevention of intraoperative hypertension crisis.

The abnormalities demonstrated by spine MRI indicate the possibility of etiology for refractory lower urinary tract symptoms in female patients / 中华泌尿外科杂志

Objective To approach the spine MRI features and its possibility of etiology for refractory lower urinary tract symptoms(LUTS) in female patients.Methods We conducted prospectively a cross sectional description study of female patients with refractory LUTS during January 16 through March 27 in 2017 based on a urologist's outpatient work.The including criteria were adult female patients with refractory LUTS which defined as having LUTS more than three months and having poor response to behavior therapy and medication treatment.The excluding criteria were patients having evidence of infection,tumor,stone in urinary tract,any central nerve system diseases,or any other diseases may potentially producing LUTS.Data collected included patients demographic information,main complains,present disease features,disease history,physical examination,urine routine,urodynamic study and spine MRI.The characteristics of clinical manifestation,urodynamic study and spine MRI were analyzed.Results During the time span of study,totally 70 cases had been diagnosed as having refractory LUTS and had qualified data of clinical recordings,urodynamic study and spine MRI.Among these 70 cases,63 (90.9％) had storage phase symptoms,11 (15.7％) had voiding phase symptoms,8 (11.4％) had postmicturition symptoms,12 (17.1％) also had disorders in defecating,45 (64.3％) had pain in lower abdomen or pelvic region.69 cases (98.6％) had urodynamic disorders,33 (47.1％) had oversensitivity of bladder,12 (17.1％) had smaller bladder volume,16(22.9％) had detrusor overactivity,15 (21.4％) had bladder outlet obstruction,39(55.7％) had detrusor underactivity.69 cases(98.6％)had spine MRI abnormalities,54(77.1％) had sacral nerve lesions,49 (70.0％) had cervical lesions,48 (68.6％) had lumbar lesions,4 had thorathic lesions.Conclusions The present study revealed extraordinary high prevalence of abnormality in urodynamic parameters and spine MRI in female patients with refractory LUTS,which implies possibility that the refractory LUTS are caused by lesions in spinal nerve system.

Factors Related to Outcome of Idiopathic Facial Palsy / 中国康复理论与实践

Objective To explore the factors related to the outcome of idiopathic facial palsy. Methods 308 patients with idiopathic fa-cial palsy were included. The data of clinic and follow-up were collected from January, 2010 to December, 2014. The data were analyzed by Logistic regression analysis. Results 210 cases (68.2%) were cured (good group) and 98 cases (31.8%) appeared sequelae of different de-grees (poor group). The age, onset of disease, type of disease, damaged section, impaired glucose control, high neutrophil-to-lymphocyte ra-tio (NLR), high blood glucose, high blood triglyceride, time and methods of invention were significant factors related to the outcome (P<0.05). Conclusion Old, servious facial nerve injury, Hunt's palsy, high damaged section, poor glucose control in the patients with diabetes, high NLR, high blood triglyceride, delay and simple invention are independent risk factors for the poor outcome of idiopathic facial palsy.

Diagnosis and treatment of patients with neurogenic bladder caused by sacral nerve root lesions / 中华泌尿外科杂志

Objective To investigate the clinical and pathological features of sacral nerve root lesions and the diagnosis and treatment for these clinical entities.Methods The clinical data of the patients with urine retention or refractory lower urinary tract symptoms (LUTS) caused by sacral nerve root lesions were retrospectively analyzed.Totally 27 patients were included in this study,including 4 cases of acute retention,6 chronic retention and 17 refractory LUTS.All patients had urodynamic disorders and sacral nerve root space-occupying lesions demonstrated by magnetic resonance imaging.All the patients received surgical treatment and were followed up one year or more.Results The pathological findings included simple cyst in 3 cases,ganglioneuroma in 5,cyst wall inflammation in 15,cyst wall hyaline degeneration in 15,and neurodegeneration in 15.Postoperatively,9 of the 10 patients with retention could voluntarily void and 1 remained suprapubic catheter drainage.All 17 patients with refractory LUTS improved significantly in terms of international prostate symptom score,visual analogue scale pain score,quality of life,maximal urinary flow rate and post void residual (P＜0.01).Conclusions Sacral nerve root lesions can be the causes of urinary retention or refractory LUTS.Surgical treatment can improve patient's voiding function and quality of life.

Effect of tolterodine on catheter-related bladder discomfort after general aneathesia operation / 中华泌尿外科杂志

Objective To determine whether a prophylactic tolterodine administration before surgical operation on non-urologic patients under general aneathesia can prevent the occurrence of catheter-related bladder discomfort (CRBD) ; and to assess patients’ tolerance to the symptoms as well as the impact on related consultation work of urologic surgeons.Methods One hundred and eighty cases of non-urology patients who need general aneathesia operations were divided into 2 groups:90 cases in tolterodine group and 90 in control group.The assessment of CRBD is categorized into 4 steps and statistics for adverse events ( dry mouth,dizzyness and facial flushing) was also conducted.A record of the patients’ needs for urologic surgical consultation during their reservation of catheter was also kept.SPSS 13.0 used in the statistical analysis of data in terms of X2 examination,where the divergence P ＜ 0.05 was regarded statisticly valid.Results 82 cases were followed up in the tolterodine group with a 24.4％ CRBD occurrence,which included 7.2％ shows moderate and severe symptoms,and there were also 23 cases with dry mouth ( 28.0％ ),4 cases with dizzyness (4.8％),13 cases with facial flussing ( 15.8％ ),and 1 case who needs further consultation (1.2％).In the 86 followed-up cases in control group,CRBD occurance rate was 54.7％,with 30.2％ showed moderate and severe symptoms,plus 2 cases suffered from severe consequences.Nine cases ( 10.5％) in control group requires further consultation ( X2 =19.499,P =0.000 ＜ 0.05 ).Conclusions A prophylactic tolterodine administration before surgery to the patients underwent general aneathesia can prevent the occurrence ofcatheter-related bladder discomfort (CRBD) and reduce the consultation work of urologic surgeons.Patients using tolterodine show a higher rate of adverse events,yet to which most patients can tolerate.

The short-term results of T-consling suspension in treating female stress urinary incontinence / 中华泌尿外科杂志

Objective To evaluate the curative effect of stress urinary incontinence (SUI) with Tconsling suspension surgery. Methods From May 2010 to September 2011,we treated 9 cases SUI with T-consling suspension surgery.The average age was 51 years (range 45 -63 years).They all suffered from stress incontinence 1 -5 years. Urodynamic test were performed preoperatively and stress urinary incontinence was confirmed.Abdominal leak point pressures is between 75 - 103 cm H2O (average 87 cm H2O),and no obvious cystocele vaginalis and others pelvic organ prolapsed disease were detected.Operation was done by transvaginal front wall incision to place T-consling suspension tape beneath the middle urethra.Results Operation time were between 15 to 25 mins,with 17 minutes on average.EBL was 5 - 30 ml.Urinary catheters were drawn 3 -4 d postoperatively.In 9 cases,8 were cured,one improved.The improved case had leakage when abdominal pressure increases,but became less significant,and the other cases had no leakage when abdominal pressure increases.The short-term cure rate was 89％. Conclusions The Tconsling suspension is safe,effective and easy to perform for the treatment of SUI,however,longer follow-up and more cases are necessary to confirm the long-term effects of this procedure.

Influence of periurethral injection of insulin-like growth factor-Ⅰ on the expression of IGF-Ⅰ and IGF-Ⅱ mRNA following urethral sphincter muscle injury in female rats / 中华泌尿外科杂志

Objective To investigate the effect of periurethral injection of insulin-like growth factor(IGF)-Ⅰ on the expression of IGF-Ⅰ and IGF-Ⅱ mRNA during regeneration period following urethral sphincter muscle injury in female rats. Methods Model of urethral sphincter muscle injury was made in female virgin SD rats (n=50) by intravaginal balloon inflation. Then the rats were divid-ed randomly into treatment group (n= 25) and control group (n= 25), treatment group accepted peri-urethral injection of 1.0μg human IGF-Ⅱ to the middle urethral muscle, control group accepted nor-mal saline injection. Five rats in each group were sacrificed at 2, 4, 6, 8, 14 day respectively and the whole urethra specimens were processed for RT-PCR to detect the expression of IGF-Ⅰ ,Ⅱ mRNA. A normal control group (n = 5) was set without intravaginal balloon inflation and injection. Results The expression of IGF-Ⅰ mRNA in control group increased at day 4, 6, 8, 14, the IGF-Ⅰ/β-actin ra-tios were 0. 58±0.15, 1.73±0.31, 2.30±0.29, 0. 46±0. 06. The expression of IGF-Ⅰ mRNA in treatment group increased at all time points, as 0. 69±0.21, 1.45±0.17, 2.25±0.45, 2.90±0.49, 1.92±0. 31. The difference was significant on day 4, 14(P<0.01), and day 8 (P<0.05) compared with the control group. The expression of IGF-Ⅱ mRNA in control group increased at day 4, 6, 8, as 0.42±0. 14, 1.51±0. 59, 1.31±1.04. The expression of IGF-Ⅱ mRNA in treatment group in-creased at day 4, 6, 8, 14, as 1.04±0.23, 1.94±0.29, 1.75±0.41, 0. 81±0.15. The significant difference was noted on day 4 (P<0. 01)compared with the control group. No expression of IGF-Ⅰand Ⅱ mRNA in the normal control group. Conclusions The expression of endogenous IGF-Ⅰ and IGF-Ⅱ mRNA was up-regulated by periurethral injection of IGF-Ⅰ during regeneration period follow-ing urethral sphincter muscle injury in female rat. Our findings suggest that IGF-Ⅰ facilitates the re-generation of the urethral muscles and may play a role in treatment of stress urinary incontinence in-duced by urethral sphincter muscle dysfunction.

A multicenter prospective clinical study on the effectiveness and safety of terazosin in the treatment of Chinese benign prostatic hyperplasia patients / 中华泌尿外科杂志

Objective To evaluate the effectiveness and safety of terazosin in the treatment of Chinese benign prostatic hyperplasia (BPH) patients. Methods A multicenter prospective postmarketing observational study was conducted from June 2007 to March 2008 in 32 urologic centers.Patients were given terazosin for 4 weeks according to the routine medical care procedures following instructions. Effectiveness evaluation included the primary endpoint focusing on the changes in IPSS total score at the end of 2nd and 4th week compared with the baseline. The secondary endpoints were the changes in Qmax and QOL at the end of 4th week, diastolic and systolic blood pressures at the end of 2nd and 4th week compared with the baseline and the discontinuation rate of terazosin within the four weeks. Safety was assessed by adverse events. Results There were 1006 patients included in this study (FAS) and 992 patients (PP) completed the study. Among them, there were 344 patients having hypertension. The total IPSS score reduced from 22.32±6. 13 at baseline to 16. 98±5.92 at the end of the 2nd week and to 14.00±5. 52 at the end of the 4th week in FAS population (P＜0. 01).The total IPSS score changed from 22.32±6.15 at baseline to 16. 96±5.93 at the end of the 2nd week and to 13. 95±5.52 at the end of the 4th week in the PP population (P＜0.01). The efficacy rate was 26.54% at the 2-week treatment and 60.64% at the 4-week treatment, which was defined as obtaining improvement by 30% compared with the baseline. Patient's IPSS in different age groups with different prostatic hyperplasia levels and patients combined with or without 5-α reductase inhibitors were all decreased significantly(P＜0.01). With 4-week treatment of terazosin, Qmax and QOL were improved significantly by 32% and 45% (P＜0.01). Terazosin decreased BPH patient blood pressure with untreated or uncontrolled hypertension (P＜0.05), but had little influence on normal blood pressure of those under control. The incidence of adverse reactions was low. The most common adverse event was dizziness (3.68%). At the end of the study, 960 subjects (95%) were taking drug continuously.Conclasions Terazosin can significantly improve the symptoms and quality of life in Chinese BPH patients with good safety and compliance.

A preliminary trial of extracorporeal shock waves for the treatment of ⅢB chronic prostatitis / 中华物理医学与康复杂志

Objective To assess the effect of extracorporeal shock waves(ESWs)as a treatment for ⅢB chronic prostatitis(CP).Methods Forty-six men with ⅢB CP were randomly divided into an experimental group (n=34)and a control group(n=12).The patients in experimental group received low energy ESW treatment,20000 impulses in 10 sessions over 2 weeks.The patients in control group received sham ESW treatment without shock waves energy under the same other conditions as in experimental group.Pain,urination and quality of life/impact were assessed with National Institutes of Health-chronic prostatitis symptom index(NIH-CPSI).Both groups were assessed at baseline,post-treatment and at a 4-week follow-up.Resuits The total NIH-CPSI scores,pain scores and quality of life/impact scores in experimental group decreased significantly post-treatment(P＜0.01),but urination scores did not(P＞0.05).Similar decreases of these scores were also found in control group post-treatment.The total NIH-CPSl scores and pain scores maintained at a lower level at the 4-week follow-up in experimental group,but the scores returned to the level as pre-treatment in control group.The effectiveness rates and prominent effectiveness rates in experimental group were significantly higher than those in control group post-treatment and at the 4-week follow-up(all P＜0.05). Conclusions ESWs was effective in the treatment for ⅢB CP.After ESWs treatment pain alleviated,symptoms reducea and quality of life improved.

The assessment of bladder and urethral function in spinal cord injury patients / 华中科技大学学报（医学）（英德文版）

The correlation between the anatomic site of spinal cord injury and real-time conditions of bladder and urethral function was assessed in order to provide a reasonable basis for the clinical treatment of neurogenic bladder. A total of 134 patients with spinal cord injuries (105 males, 29 females; averaged 34.1 years old) were involved in this retrospective analysis, including urodynamic evaluation, clinical examination and imaging for anatomical position, and Bors-Comarr classification. The associations between the levels of injury and urodynamic findings were analyzed. The results showed that mean follow-up duration was 16.7 months (range 8-27 months). Complete spinal cord injuries occurred in 21 cases, and incomplete spinal cord injuries in 113 cases. Of the 43 patients with upper motor neuron (UMN) injuries, hyperreflexia and (or) detrusor sphincter dyssynergia were demonstrated in 30 (69.8%), 31 (72.1%) suffered low bladder compliance (less than 12.5 mL/cmH(2)O), 28 (65.1%) had high detrusor leak point pressures (greater than 40 cmH(2)O), and 34 (79.1%) had residual urine. Of the 91 patients with lower motor neuron (LMN) injuries, areflexia occurred in 78 (85.7%), high compliance in 75 (82.4%), low leak point pressures in 80 (87.9%), and residual urine in 87 (95.6%), respectively. The associations between the anatomical site of spinal cord injury and urodynamic findings were ill defined. In patients with spinal cord injury, this study revealed a significant association between the level of injury and the type of voiding dysfunction. The anatomical site of spinal cord injury can not be predicted in real-time condition of bladder and urethral function. Management of neurogenic bladder in patients with spinal cord injury must be based on urodynamic findings rather than inferences from the neurologic evaluation.

P2X3 receptor expression in DRG and bladder detrusor of an animal model of neurogenic bladder and ure-thra / 中华物理医学与康复杂志

Objective To investigate the P2X3 receptor expression in L6-S1 dorsal root ganglion (DRG)and bladder detrusor in a rat model of neurogenic bladder and urethra. Methods Eighty Sprague-Dawley rats wererecruited and randomly divided into a sacral injury group, a suprasacral injury group and a control group. Spinal tran-section was performed to establish the animal model of neurogenic bladder and urethra in rats of the sacral injurygroup and suprasacral injury group. Check the P2X3 receptor expression in DBG and bladder detrusor among thethree groups by Western blot test at 20 days after model establishment. Results P2X3 receptor expression in L6-S1DRG of sacral injury group was significantly less than that of the suprasacral injury group, which was in turn signifi-cantly higher than that of the control group. P2X3 receptor expression in bladder detrusor of sacral injury group wassignificantly lower than that of the suprasacral injury group, which was in turn significantly higher than that of thecontrol group. Conclusion There was close relationship between P2X3 receptor expression and dysfunction of blad-der and urethra.

Present situation in the study of antisperm antibodies / 中华男科学杂志

Immune factors account for 5%-15% of male infertility. Because of the diversity in molecular weight, structure and location, sperm antigens play different roles in immune infertility. Antisperm antibodies (AsAb) influence sperm function not only by direct action, but also by changing the local microenvironment indirectly. This paper reviews the progress in the studies of the implication of human sperm antigens, the function, mechanisms, categories and titer of AsAb in male infertility.

Advances in clinical application of nocturnal penile tumescence monitoring to diagnosis and treatment of erectile dysfunction / 中华男科学杂志

Nocturnal penile tumescence is a normal physiological behavior of males. Nocturnal penile tumescence monitoring is one of the most effective methods to differentiate between organic and psychological erectile dysfunctions. Nocturnal penile tumescence monitoring has reportedly been applied to the diagnosis and treatment of erectile dysfunction as well as to the researches on the mechanism of nocturnal penile tumescence.

Urodynamic study of neurogenic bladder model after spinal cord injury in rat / 中华物理医学与康复杂志

Objective To observe the urodynamic change after spinal cord injury at different levels and the relationship with neurogenic dysfunction of bladder and urethra. Methods Eighty female rats were divided into a control group (20 rats) , a suprasacral spinal cord injury group (30 rats) and a sacral spinal cord injury (30 rats). The urodynamic exam was performed with all the rats before and 20 days after the spinal cord injury model was established by surgical operation. Results The maximum bladder volume and compliance in the su- prasacral injury group were significantly less than the sacral spinal cord injury group and the control, the maxi- mum volume and compliance in sacral spinal cord injury group were significantly less than the control. The DLPP in suprasacral injury group was significantly higher than that in the sacral spinal cord injury group and the con- trol, the DLPP in sacral spinal cord injury group was significantly less than that in the control group. Conclu- sion Urodynamic study is very useful for the early diagnosis and individualized treatment of the neurogenic bladder after spinal cord injury.

Expression of Multidrug-associated Protein, P-glycoprotein, P53 and Bcl-2 Proteins in Bladder Cancer and Clinical Implication / 华中科技大学学报（医学）（英德文版）

The expression of multidrug resistant proteins in bladder cancer and clinical implication was studied. Expression of multidrug-associated protein (MRP), P-glycoprotein (P-gp), P53 and Bcl-2 proteins were detected by using immunohistochemical method in 40 specimens of bladder transitional cell carcinoma. The results showed that the positive rate of MRP, P-gp, P53 and Bcl-2 was 52.5 %, 57.5 %, 47.5 % and 62.5 % respectively. The positive rate of MRP, P-gp, P53 and Bcl-2 in the grade Ⅰ, Ⅱ and Ⅲ of tumors was 46.3 %, 38.5 %, 38.5 %, 23.1 %； 52.9 %, 39.8 %, 47.1 %, 76.4 %； 60.0 %, 80.0 %, 60.0 %, 90.0 % respectively. The positive rate of MRP, P-gp, P53 and Bcl-2 in 24 primary tumor specimens was 37.5 %, 41.7 %, 33.3 %, 45.8 % and that in 16 cases in recurrent specimens receiving chemotherapy 75.0 %, 81.3 %, 68.8 %, 87.5 % respectively. It was suggested the positive rate of MRP, P-gp, P53 and Bcl-2 was increased with the advance of tumor grade. The positive rate of four proteins in all recurrent cases was significantly increased (P<0.05). The expression of MRP, P-gp, P53 and Bcl-2 proteins might be the important factors for chemotherapy failure.

Expression of Multidrug-associated Protein, P-glycoprotein, P53 and Bcl-2 Proteins in Bladder Cancer and Clinical Implication / 华中科技大学学报（医学）（英德文版）

The expression of multidrug resistant proteins in bladder cancer and clinical implication was studied. Expression of multidrug-associated protein (MRP), P-glycoprotein (P-gp), P53 and Bcl-2 proteins were detected by using immunohistochemical method in 40 specimens of bladder transitional cell carcinoma. The results showed that the positive rate of MRP, P-gp, P53 and Bcl-2 was 52.5 %, 57.5 %, 47.5 % and 62.5 % respectively. The positive rate of MRP, P-gp, P53 and Bcl-2 in the grade Ⅰ, Ⅱ and Ⅲ of tumors was 46.3 %, 38.5 %, 38.5 %, 23.1 %； 52.9 %, 39.8 %, 47.1 %, 76.4 %； 60.0 %, 80.0 %, 60.0 %, 90.0 % respectively. The positive rate of MRP, P-gp, P53 and Bcl-2 in 24 primary tumor specimens was 37.5 %, 41.7 %, 33.3 %, 45.8 % and that in 16 cases in recurrent specimens receiving chemotherapy 75.0 %, 81.3 %, 68.8 %, 87.5 % respectively. It was suggested the positive rate of MRP, P-gp, P53 and Bcl-2 was increased with the advance of tumor grade. The positive rate of four proteins in all recurrent cases was significantly increased (P<0.05). The expression of MRP, P-gp, P53 and Bcl-2 proteins might be the important factors for chemotherapy failure.