CH3 CN@open-C60 : An Effective Inner-Space Modification and Isotope Effect Inside a Nano-Sized Flask.

Despite several small molecules being encapsulated inside cage-opened fullerene derivatives, such species have not considerably affected the structures and properties of the outer carbon cages. Herein, we achieved an effective inner-space modification for an open-cage C60 derivative by insertion of a neutral CH3 CN molecule into the cavity. The CH3 CN@open-C60 thus obtained showed an enhanced polarity, thus affording an easy separation from a mixture containing the empty cage by column chromatography on silica gel, without the preparative HPLC that was needed for previous cases. The less negative reduction potentials with respect to those of empty cage reflect the decreased energy level of the LUMO, which is supported by the DFT calculations. NMR spectroscopy, single-crystal X-ray analysis, and theoretical calculations revealed that both the presence of the encapsulated CH3 CN and cage deformation caused by the CH3 CN play an essential role in the change of the electronic properties. Furthermore, the favored binding affinity of deuterated acetonitrile CD3 CN with internal C60 surface is discussed.

An innovative method for occluding the urethral meatus and accessing urethra strictures in retrograde urethrography in males.

OBJECTIVES: To observe and evaluate the effectiveness and safety of using a sponge plug method to occlude the urethral meatus during retrograde urethrography (RUG) for accessing male urethral strictures. METHODS: 40 male patients with a mean age of 51.4 years and a history of urethral injury were primarily diagnosed with urethral stricture using a urethrocystoscope. RUG was performed using a ureteral catheter with a sponge plug inserted into the external meatus. Iodixanol, a contrast medium, was injected into the urethra or bladder for performing RUG and voiding cystourethrography (VCUG). The patients were positioned obliquely to obtain urethrograms. RESULTS: All X-ray radiologic procedures for performing urethrography were successful without any overflow of contrast liquid observed. In all cases, the sponge plugs became visible in the resulting images. The external meatuses were directly visualized in all cases on the obtained images, allowing identification of the number, location, and length of strictures as well as coexistent pathologies such as fistulas. In one case, the plug slipped off the meatus immediately after completing the procedure. The pain Visual Analogue Scale (VAS) was 0 to 2, mean 0.35. No instances of complication or adverse reactions was observed. CONCLUSIONS: The sponge plug effectively occludes the external urethral meatus for retrograde urethrography, enabling visualization of the actual caliber of the entire urethra, including the strictures and external meatus, by filling it with contrast liquid. This technique is safe and well-tolerated by patients.

An H2 O2 Molecule Stabilized inside Open-Cage C60 Derivatives by a Hydroxy Stopper.

An H2 O2 molecule was isolated inside hydroxylated open-cage fullerene derivatives by mixing an H2 O2 solution with a precursor molecule followed by reduction of one of carbonyl groups on its orifice. Depending on the reduction site, two structural isomers for H2 O2 @open-fullerenes were obtained. A high encapsulation ratio of 81 % was attained at low temperature. The structures of the peroxosolvate complexes thus obtained were studied by 1 H NMR spectroscopy, X-ray analysis, and DFT calculations, showing strong hydrogen bonding between the encapsulated H2 O2 and the hydroxy group located at the center of the orifice. This OH group was found to act as a kinetic stopper, and the formation of the hydrogen bonding caused thermodynamic stabilization of the H2 O2 molecule, both of which prevent its escape from the cage. One of the peroxosolvates was isolated by HPLC, affording H2 O2 @open-fullerene with 100 % encapsulation ratio, likely due to the intramolecular hydrogen-bonding interaction.

Outcomes of early endoscopic realignment for blunt straddle injuries to the bulbar urethra: a single-center retrospective study.

BACKGROUND: The optimal acute management of patients with blunt straddle injury to the bulbar urethra remains in question. Conventionally, suprapubic diversion with delayed urethroplasty can always be considered, if necessary, but the role of early endoscopic realignment (EER) in the acute management of blunt straddle injuries to bulbar urethra is controversial. We report our clinical experience and outcomes with EER for patients with straddle injury to the bulbar urethra in a level one trauma center. METHODS: We retrospectively reviewed 44 male patients who were transferred to our trauma center between January 2013 and January 2019 for acute management of blunt straddle injury to the perineum leading to bulbar urethra injuries. We reviewed the medical records of those patients to identify demographics, emergency management and clinical outcomes. RESULTS: The most common injury mechanism was falling onto the perineum (n = 27, 61.4%), followed by motorcycle accident (n = 11, 25.0%) and bicycle accident (n = 6, 13.6%). Of the 44 patients, 14 (31.8%) were partial bulbar urethral ruptures and 30 (68.2%) were complete bulbar urethral ruptures. 31 (70.5%) patients successfully underwent EER and 13 (29.5%) patients failed attempted EER. the difference between successful EER attempts and failed ones in term of injured urethral mucosa integrity was statistically significant (P = 0.035, OR 8.667,95% CI: 0.998-75.235). In patients who underwent successful EER, urethral stricture occurred after catheter removal at a median of 8 (1-28) months in 24 (77.4%) patients and the mean stricture length was 1.8 ± 0.8 (0.5-3.0), which was not statistically significant when compared with those who failed EER (P = 0.103). Overall, 21 out of 24 (87.5%) patients with strictures after EER were successfully managed by urethroplasty. CONCLUSIONS: Although achieving a successful EER attempt is relatively easy for most patients with straddle injury to the bulbar urethra, it does not improve urethral healing significantly. Most patients with stricture formation after EER have to be cured with urethroplasty.

Modified cystoscopy-assisted laparoscopic Y-V plasty for recalcitrant bladder neck contracture.

BACKGROUND AND AIM: Recalcitrant bladder neck contracture (BNC) is a common complication after transurethral resection of the prostate. Our aim was to show the outcomes of a modified cystoscopy-assisted laparoscopic Y-V plasty for BNC treatments. MATERIAL AND METHODS: We retrospectively evaluated a series of 27 patients who underwent a modified cystoscopy-assisted laparoscopic Y-V plasty for recalcitrant BNC from January 2017 to September 2019. Urinary flow rate, international prostate symptom score (IPSS), international index of erectile function-5 (IIEF-5) and bladder urethral examination by cystoscopy were performed preoperatively and postoperatively, respectively. RESULTS: All patients underwent the procedure successfully and no serious complication occurred. The median surgery time was 68.6 min without massive bleeding. The median follow-up time was 14.2 months and no patients had urinary incontinence. The maximum urine flow rate 3 months after surgery was significantly higher than prior to surgery (17.7 ± 2.1 ml/s vs. 8.2 ± 1.2 ml/s, p < 0.05). The IPSS was significantly decreased compared with the preoperative score (5.7 ± 2.3 vs. 19.2 ± 1.4, p < 0.05). The cystoscopy showed a wide bladder neck and the survival bladder flap in prostate urethral 3 months postoperatively in 92.6% (25/27) patients. CONCLUSIONS: The modified cystoscopy-assisted laparoscopic Y-V plasty is a feasible and effective technique for recalcitrant BNC treatment.

Comparison of two different methods of establishment of canine urethroplasty model: an experimental trial.

BACKGROUND: Graft substitute urethroplasty is recommended for patients with long segment anterior urethral stricture. The therapeutic effects of the grafts need to be validated on the animal models. Therefore the aim of this study was to compared the operative time, blood loss, intra- and post- operative complications of two different methods of establishment of canine urethroplasty model. METHODS: Twelve Beagle dogs were randomly separated into control and experimental group using a random number table. Six animals in the control group received the conventional urethroplasty, while the other 6 in the experimental group received the modified procedures. Tube cystostomy and urethroplasty were performed in the control group. The cystostomy not the tube cystostomy were performed in the experimental group, and the testes were simultaneously removed with the scrotum. Per- and postoperative outcomes, complications were evaluated. RESULTS: The urethroplasty were successfully performed for all dogs and all of these procedures were done by the same surgeon. The median operative time in the control and experimental groups was 186.8 min and 188.7 min respectively. The blood loss in the control and experimental groups was 40.8 ml and 45.8 ml respectively. No intraoperative complications occurred. 3 animals in the control group developed acute urinary retention after the accidental removal of suprapubic bladder tube and the cystostomy was done again. There was no occurrence of urinary retention in the experimental group. 4 animals in the control group developed the perineal hematoma, in which one animal had the urine leakage and incision infection. Perineal hematoma occurred in only one animal in the experimental group. CONCLUSION: The occurrence of urinary retention and perineal hematoma decreased in the modified group, in which the cystostomy not the tube cystostomy were performed and the testes with the scrotum were simultaneously removed.

Retraction Note: Association between serum vitamin D levels and the risk of kidney stone: evidence from a meta-analysis.

The Editors are retracting this article [1] because post-publication peer review has identified multiple errors in the methodology of this meta-analysis, which invalidate the conclusions drawn.

Association between serum vitamin D levels and the risk of kidney stone: evidence from a meta-analysis.

BACKGROUND: Many epidemiological studies have conducted to evaluate the association between serum vitamin D levels and the risk of kidney stone. The aim of this study was to summarize the evidence from epidemiological studies between them. METHODS: Pertinent studies were identified by a search of PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure (CNKI) and China Biology Medical literature up to July 2015. Standardized mean difference (SMD) was conducted to combine the results. Random-effect model was used. Publication bias was estimated using Egger's regression asymmetry test. RESULTS: Seven articles involving 451 kidney stone cases and 482 controls were included in this meta-analysis. Our pooled results suggested that kidney stone patients had a significantly higher serum vitamin D level compared with controls [summary SMD = 0.65, 95 % CI = 0.51, 0.79, I(2) = 97.0 %]. The associations were also significant both in Europe [SMD = 0.35, 95 % CI = 0.17, 0.53] and in Asia [SMD = 1.00, 95 % CI = 0.76, 1.25]. No publication bias was found. CONCLUSIONS: Our analysis indicated that serum vitamin D level in kidney stone patients was significantly higher than that in non-kidney stone controls, both in Europe and Asia populations.

[Management of female urethral obliteration with the rotary excision appliance].

OBJECTIVE: To describe a new technique using the rotary excision appliance for the treatment of female urethral obliteration and to evaluate the effect of the management. METHODS: Between October 2000 and July 2013, 5 cases of female urethral obstruction (age from 23 to 65 years, time to treatment from 3 to 60 months, obliteraion length from 0.5 to 1.8 cm) were managed using the rotary excision appliance and the patients had been followed up. RESULTS: After a mean of 32.4 months (range: 5 to 75 months) of follow-up, normal micturation had been achieved in all the patients. The maximal urinary flow rate (MFR) ranged from 15 to 28 mL/s (mean 20.6 mL/s). Three patients were continent and 2 patients had slight incontinence. CONCLUSION: The rotary excision appliance is a useful instrument for the management of female urethral obliteration. Our Long-term follow-up provides further support for use of this technique by demonstrating that urethral continuity can be established without increased incidence of stricture formation or incontinence.

[Clinical characteristics of adrenal gland trauma].

OBJECTIVE: To explore the clinical characteristics of adrenal gland trauma. METHODS: A retrospective review was performed for 17 patients presenting with adrenal gland injury diagnosed by computed tomography (CT). There were 11 males and 6 females with an average age of 14-60 (38 ± 12) years. The injuries occurred as the consequence of motor vehicle crash (n = 13) and secondarily to a fall (n = 4). The average time from accident to admission was 5.0 ± 4.1 hours and the average injury severity score (ISS) 31.5 ± 10.3. Among 9 patients with throat injuries, there were pulmonary contusion, hematopneumothrax and rib fracture, followed by extremity fracture (n = 8) and pelvis fracture (n = 7). Additionally, 3 patients had injuries to vertebral column and 4 suffered closed cranial injury. There were 3 patients with liver injury, including subcapsular hematoma (n = 2) and laceration (n = 1). The urinary related injuries included renal contusion and laceration (n = 5) and urethral injury (n = 1). Among them, 15 had injuries to right adrenal glands and 2 to left ones. The CT findings of adrenal trauma were adrenal contusion and focal hematoma. All patients received conservative treatment. RESULTS: No patient died. The complications of urinary tract infection (n = 6) , deep vein thrombosis (n = 3), pneumonia (n = 3) and gastrointestinal ulceration (n = 2) improved with conservative treatment.Vital signs were all stable after 1 week treatment except for 1 patient operated for intracranial hematoma. The average follow-up period was 2.0- 12.0 (5.5 ± 2.7) weeks for 11 patients. The re-examination of CT showed a absorption of hematoma. And 2 cases had a complete absorption. CONCLUSIONS: Adrenal gland injury is rare and there is a right-sided preponderance.It is associated with high injury severity.For a lack of obvious clinical manifestations, missed diagnosis is frequently made. CT scan is the first-choice diagnostic tool for adrenal gland injury. Conservative treatment is often satisfactory and hormonal supplement unnecessary.

[Surgical treatment of bone metastases from renal cell carcinoma].

OBJECTIVE: To retrospectively analyze the survival of renal cell carcinoma patients with bone metastases, evaluate the effect of treatment and identify the prognostic factors in these patients. METHODS: A total of 66 renal cell carcinoma patients with bone metastases treated at our hospital between October 1990 and October 2010 were divided into 3 groups: solitary bone metastasis referred for radical surgery (n = 19); palliative surgery for solitary/multiple bone metastasis (n = 31); extraosseous metastasis without orthopedic surgery (n = 16). The effects of different variables on survival were determined according to the Kaplan-Meier method and Log-Rank test. And Cox proportional hazard regression model was used to estimate the prognostic factors. RESULTS: Their mean follow-up period was 25 (6-68) months. The survival significantly improved if bone metastases were solitary (45 vs 29 and 13 months, both P < 0.01), there was no vertebral bone involvement (31 vs 10 months, P < 0.01) and radical surgery was performed (50 vs 28 and 13 months, both P < 0.01). Age, gender, tumor size, alkaline phosphatase and lactate dehydrogenase had no effect on survival (all P > 0.05). Based on Cox regression analysis, survival was influenced by the number of metastasis foci (RR = 0.259, 95%CI:0.075-0.897) , type of procedure (RR = 17.845, 95%CI:4.246-74.992) and vertebral bone involvement (RR = 4.526, 95%CI:1.896-10.803) (all P < 0.05). CONCLUSIONS: Surgery is a better option for achieving local tumor control, providing good function and increasing the survival of patients with bone metastases. And radical resection is indicated for the patients with a solitary metastasis.

An open-cage bis[60]fulleroid as an electron transport material for tin halide perovskite solar cells.

An open-cage bis[60]fulleroid (OC) was applied as an electron transport material (ETM) in tin (Sn) halide perovskite solar cells (PSCs). Due to the reduced offset between the energy levels of Sn-based perovskites and ETMs, the power conversion efficiency (PCE) of Sn-based PSCs with OC reached 9.6% with an open-circuit voltage (VOC) of 0.72 V. Additionally, OC exhibited superior thermal stability and provided 75% of the material without decomposition after vacuum deposition. The PSC using vacuum-deposited OC as the ETM could afford a PCE of 7.6%, which is a big leap forward compared with previous results using vacuum-deposited fullerene derivatives as ETMs.

[Replantation of amputated penis in Chinese men: a meta-analysis].

OBJECTIVE: To evaluate the methods for the replantation of the amputated penis in Chinese men. METHODS: We performed a meta-analysis on the domestic literature relating replantation of the amputated penis, particularly its successful methods published from 1964 to January 2012. RESULTS: We identified 109 reports on 111 cases of replantation of the amputated penis that met the inclusion criteria, including 103 adults and 8 children. The mean age, warm ischemia time and total ischemia time were 29 +/- 11 years (range 2 - 56 years), 5.2 +/- 5.7 hours (range 0 - 38 hours) and 6.3 +/- 5.7 hours (range 1 - 38 hours). Fifty-three of the cases were treated by microsurgery and 44 by non-microsurgery. Complications occurred in 81 (73%) of the cases, including ED in 14 cases, urethral stricture in 16, urinary fistula in 8, skin necrosis in 58 and skin sensory abnormality in 31. The incidences of ED, urethral stricture and urinary fistula exhibited significant differences between the microsurgery and non-microsurgery groups of the partial amputation patients (P < 0.05). The incidence of ED was correlated negatively with the number of anastomosed dorsal nerves (r = -0.3, P = 0.05), anastomosis of dorsal veins (r = -0.2, P = 0.02) and anastomosis of arteries (r = -0.2, P = 0.03), but positively with skin sensory abnormality (r = 0.4, P < 0.01), that of urethral stricture negatively with the anastomosis of dorsal nerves (r = -0.2, P = 0.02) and arteries (r = -0.2, P = 0.016), but positively with the anastomosis of corpus cavernosum (r = 0.3, P = 0.01), that of skin necrosis negatively with the total number of anastomosed blood vessels (r = -0.2, P = 0.04), and that of complications negatively with the number of anastomosed dorsal nerves (r = -0.3, P = 0.01), dorsal veins (r = -0.2, P = 0.04), arteries (r = -0.2, P = 0.023) and micro-anastomosis (r = -0.3, P < 0.05). CONCLUSION: Early micro-anastomosis of the most possible penile dorsal veins, arteries and dorsal nerves is essential for the survival of the replanted penis and reduction of complications, and therefore can be regarded as a "standard" method for penile replantation in China.

[Differences of urodynamic tests between patients of detrusor hyperactivity with impaired contractility with and without bladder outlet obstruction and effect of anticholinergic medications in these patients].

OBJECTIVE: To explore the differences of urodynamic parameters and lower urinary symptoms between detrusor hyperactivity with impaired contractility (DHIC) patients and DHIC patients with bladder outlet obstruction (BOO) and evaluate the effects and risks of anticholinergic medications in these patients. METHODS: A retrospective analysis was performed in 56 DHIC patients at our hospital between February 2000 to February 2011. Among them, 19 patients were complicated with BOO. Urodynamic studies were conducted and lower urinary symptoms assessed in all patients. Then the urodynamic parameters and lower urinary symptoms scores were compared between the DHIC and DHIC plus BOO patients. Among them, 27 received anticholinergic medications and there were 11 BOO patients. After 2-month anticholinergic medications, the differences of lower urinary symptom score were analyzed and anticholinergic-induced retention was also investigated. RESULTS: As compared with the DHIC patients, the DHIC plus BOO patients had a higher post-voiding residual urine (70 (23 - 106) vs 20 (10 - 81) ml, P = 0.02), higher total international prognostic scoring system (IPSS) score (25.6 ± 3.9 vs 22.1 ± 4.1, P = 0.00) and higher total voiding symptom score (15.3 ± 2.9 vs 11.8 ± 3.3, P = 0.00). After 2-month anticholinergic medications, the IPSS score of DHIC plus BOO patients decreased from 25.7 ± 4.6 to 23.6 ± 4.9 (P = 0.01), 2/11 patients developed urinary retention. The IPSS scores of DHIC patients decreased from 22.8 ± 4.7 to 21.4 ± 4.6 (P = 0.01) and none had urinary retention. CONCLUSIONS: The DHIC plus BOO patients have more aggravated bladder empting and more severe lower urinary symptoms especially during voiding phase. Anticholinergic medications may alleviate the lower urinary symptoms in DHIC and DHIC plus BOO patients. But anticholinergic-induced retention is common among the DHIC plus BOO patients.

[Aggressiveness and extent of prostatic inflammation relates with serum PSA levels in type IV prostatitis].

OBJECTIVE: To investigate the relationship of the histopathologic grade and extent of prostatic inflammation with the level of serum PSA in patients with type IV prostatitis. METHODS: We performed transrectal ultrasound-guided prostate biopsy for 120 patients suspected of prostate cancer and included in this study only those with benign prostate hyperplasia (BPH) and prostatitis (n = 46), excluding the cases with prostate cancer and those with BPH but no prostatitis. We evaluated the relationship between prostatic inflammation and serum PSA levels based on the three-grade pathohistologic criteria for the extent, location and aggressiveness of prostatic inflammation. The serum tPSA levels, fPSA levels, % fPSA, and PSAD were compared among different groups. RESULTS: As for the extent of inflammation, 35 of the 46 included cases were grade I (tPSA: [8.46 +/- 4.09] microg/L; fPSA: [1.75 +/- 0.93] microg/L; PSAD: 0.15 +/- 0.11), 7 were grade II (tPSA: [15.26 +/- 5.26] microg/L; fPSA: [2.54 +/- 0.72] microg/L; PSAD: 0.26 +/- 0.07) and 4 were grade III (tPSA: [21.05 +/- 7.58] microg/L; fPSA: [3. 19 +/- 1.13] microg/L; PSAD: 0.42 +/- 0.19), with statistically significant differences among the three groups in the levels of tPSA (P = 0.001), fPSA (P = 0.008) and PSAD (P < 0.001). Regarding the location of inflammation, 19 cases were grade I, 17 were grade II and 10 were grade II, with no significant differences in tPSA, fPSA and %fPSA among the three grades (P > 0.05). As for the aggressiveness of inflammation, 32 cases were grade I (tPSA: [8.37 +/- 4.07] microg/L; fPSA: [1.76 +/- 0.93] microg/L; PSAD: 0.14 +/- 0.11), 10 were grade II (tPSA: [13.30 +/- 5.69] microg/L; fPSA: [3.27 +/- 2.21] microg/L ; PSAD: 0.25 +/- 0.06) and 4 were grade III (tPSA: [21.05 +/- 7.58] microg/L; fPSA: [3.19 +/- 1.13] microg/L; PSAD: 0.42 +/- 0.19), with statistically significant differences among the three grades in the levels of tPSA (P = 0.002), fPSA (P = 0.024) and PSAD (P < 0.001). The extent of inflammation was positively correlated with the levels of tPSA (r = 0.6, P < 0.001), fPSA (r = 0.5, P = 0.001) and PSAD (r = 0.6, P < 0.001), and so was the aggressiveness of inflammation (tPSA: r = 0.5, P < 0.001; fPSA: r = 0.4, P = 0.008; PSAD: r = 0.7, P < 0.001), but a negative correlation was found between the aggressiveness of inflammation and %fPSA (r = -0.4, P = 0.013). CONCLUSION: The aggressiveness and extent of prostatic inflammation in asymptomatic prostatitis patients are significantly correlated with the level of serum PSA, which may help pathologists to avoid unnecessary repeated biopsies for patients with high-grade prostatitis.

GPNMB overexpression is associated with extensive bone metastasis and poor prognosis in renal cell carcinoma.

Glycoprotein non-metastatic protein B (GPNMB) promotes bone metastasis (BM) in various types of cancer. However, GPNMB expression and its function in patients with renal cell carcinoma (RCC) and BM is still unknown. Therefore, the clinical significance of GPNMB and its biological function in RCC with BM was investigated in the present study. A total of 31 patients with RCC and BM were retrospectively collected. The association between GPNMB protein expression level on the primary tumor and the clinicopathological characteristics of the patients was analyzed. Kaplan-Meier analysis was used to investigate the association between GPNMB expression and the prognosis of the patients. The effects of GPNMB inhibition on cell proliferation, migration and invasion in RCC cells were investigated using short hairpin (sh)RNA. High GPNMB expression level was significantly associated with the number (P=0.001) and the extent of BM (P=0.001), Fuhrman grade (P=0.037), and ERK expression level (P=0.003) of the primary tumor. In addition, GPNMB overexpression was significantly associated with poor prognosis with respect to overall survival time (P=0.001). Furthermore, a specific shRNA sequence targeting the GPNMB gene was constructed and transduced into the ACHN cell line, using a lentivirus vector to obtain a stable cell line with low mRNA expression level of GPNMB. Low GPNMB expression level inhibited RCC cell proliferation, which was measured using a Cell Counting Kit-8 assay. Cell migration and invasion ability was significantly decreased in GPNMB knockdown RCC cells compared with that in cells transduced with the negative control shRNA. In addition, the protein expression levels of phosphorylated ERK were lower in the GPNMB shRNA-transduced ACHN cells compared with those in the control cells. Therefore, these results suggested that GPNMB plays an important role in tumor progression in RCC with BM. Furthermore, it might serve as a predictive marker for BM and as a poor prognostic factor in RCC with BM. GPNMB downregulation suppressed the proliferation, migration and invasion of the RCC cells, which may be mediated through the inhibition of the ERK signaling pathway.

[Analysis of lower urinary tract symptoms in patients with lumbar disk herniation].

OBJECTIVE: To evaluate the characteristic and clinical significance of lower urinary tract symptoms (LUTS) caused by lumbar disk herniation. METHODS: A total of 80 male patients from February 2000 to April 2010 in our hospital with lumbar disk herniation underwent an urodynamic test. And they were divided into the normal bladder function group (Group A), the early-stage of bladder dysfunction group (Group B) and the late-stage of bladder dysfunction group (Group C) according to the urodynamic results. LUTS in these patients were assessed by the international prostate symptom score (IPSS) and quality of life (QOL) questionnaire. The results were analyzed statistically among these three groups. RESULTS: In Groups A (n=30), B (n=22) and C (n=28), the total IPSS scores were 9.4±4.6, 11.3±3.3 and 15.0±3.4 while the QOL scores 2.1±1.1, 2.2±1.0 and 3.4±1.3 respectively. The total voiding symptom scores were 3.8±2.7, 6.2±2.6 and 10.4±3.1 respectively and the differences were significant (all P<0.05). The total storage symptom scores were 5.6±3.4, 5.1±2.9 and 4.6±2.3 in 3 groups respectively and the difference was insignificant (P>0.05). Between Groups A and B, the differences of total voiding symptom score were significant (P<0.01) while those of the total IPSS and QOL score were insignificant (both P>0.05). Between Groups B and C, the differences of the total IPSS, QOL score and total voiding symptom score were significant (all P<0.05). CONCLUSIONS: The LUTS caused by lumbar disk herniation are notable during the late stage of bladder dysfunction. As one typical early manifestation, the voiding symptom may aid an early diagnosis of the disease.

Clinical Characteristics and Prognosis of Renal Cell Carcinoma With Spinal Bone Metastases.

BACKGROUND: The prognosis of renal cell carcinoma (RCC) with spinal bone metastasis (sBM) varies greatly. In this study, we aimed to define the clinical characteristics and prognostic factors of RCC with spinal bone metastasis (sBM) in our center. METHODS: The clinical and medical records of RCC patients with sBMs were collected. The gender, age, time of BM, the extent of BM, the number of BMs, the presence or absence of visceral metastasis, and the pathological type of BM were investigated. All patients were followed up regularly. Overall survival (OS) was calculated from the date of BMs diagnosis to death or last follow-up using Kaplan-Meier method and modelled with Cox regression analysis. RESULTS: Forty-three RCC patients with sBM were collected. sBM was found synchronously in 30 patients (70%) and metachronously in 13 patients (30%). The median survival time was 30 months in 13 patients (30%) with solitary sBM and 19 months in 30 patients (70%) with multiple sBMs (P = 0.002). Visceral metastasis occurred in 12 patients (28%) with the median survival time of 17 months, while the other 31 patients (72%) had no visceral metastasis with the median survival time of 29 months (P<0.001). En-block resection was done in 10 patients with median survival time of 40.1 months. Non-en-block resection were done in 33 patients with median survival time of 19.7 months (P<0.001). Multivariate COX regression analysis showed that MSKCC score, number of BM, visceral metastasis, and en-block resection are the independent prognosis factors of RCC patients with sBM. CONCLUSIONS: MSKCC risk stratification, number of sBM, visceral metastasis and en-block resection are significant prognostic factors for OS in RCC patients with spinal BM. Therefore, for selected patients who has solitary spinal BM with no visceral metastasis, en-block resection of spinal BM can potentially prolong survival and is the treatment of choice.

Cell-Seeded Acellular Artery for Reconstruction of Long Urethral Defects in a Canine Model.

The management of urethral stricture remains a major therapeutic challenge in clinics. Herein, we explored the feasibility of reconstructing a relatively long segment of the urethra by the cell-seeded acellular artery in a canine model. The acellular arterial matrix was obtained from the excised carotid artery of donor dogs. Autologous adipose-derived stem cells (ADSCs) from 6 male dogs were grown and seeded onto the premade acellular arterial matrix. A 3 cm long segment of the urethra was resected in 12 male dogs. Urethroplasty was performed with the acellular arterial matrix seeded with ADSCs in 6 animals and without cells in 6. Serial urethrography was performed at 1 and 3 months postoperatively. Wide urethral calibers without any signs of strictures were confirmed in all 6 animals in the experimental group. In contrast, urethral stricture was demonstrated in 3 animals in the control group. The graft was highly epithelialized and smooth in the experimental group, while graft contracture and scar formation were showed in the control group. Histologic analysis of the cell-seeded arterial matrix at 1 month confirmed the presence of multilayered urothelium and muscle. The levels of tissue formation developed over time with a progressive increase in muscle content. In contrast, extensive fibrosis and sparse smooth muscle were seen in animals treated with matrix without ADSCs. This study provides preclinical evidence that the ADSC-seeded arterial matrix can be used as a tubularized scaffold in the reconstruction of 3 cm long urethral defect in a male canine model. The ADSC-seeded arterial matrix remodels and regenerates normal-appearing urethral tissue layers over time.

[Clinical comparison of flexible endoscopic realignment with traditional open realignment].

OBJECTIVE: To evaluate the clinical value of flexible endoscopic realignment for posterior urethral disruption as compared with traditional open realignment. METHODS: A total of 58 patients suffering posterior urethral disruption in Beijing Jishuitan Hospital from January 2003 to May 2009 were examined. Twenty-three patients (Group A) were performed with flexible endoscopic realignment and 35 patients (Group B) were performed with traditional open realignment. The operation duration and post-operative complications were compared between two groups. RESULTS: All operations were successfully performed. The operative duration was significantly shorter in Group A than that in Group B [(29 +/- 10) min vs (58 +/- 11) min, P = 0.000]. Also, the patients in Group A had a significantly decreased rate of stricture and false urethral passages formation (17.4% vs 42.9%, 0 vs 20%, both P < 0.05). There were no significant difference in urinary infection, repeat procedures, incontinence and impotence between two groups (P > 0.05). CONCLUSION: As compared with traditional open realignment, flexible endoscopic realignment has the advantages of short operation duration, lesser trauma and fewer complications. Therefore it is an excellent method for the treatment of urethral injury.