Retzius-sparing technique independently predicts early recovery of urinary continence after robot-assisted radical prostatectomy.

Robot-assisted radical prostatectomy (RARP) is the conventional surgical treatment option for localised prostate cancer. We investigated factors which may be associated with recovery of early urinary continence (EUC), including the use of the Retzius-sparing technique (RS-RARP). From March 2018 to December 2018, 501 consecutive patients underwent RARP at our high-volume institution. Four hundred and thirty-one patients had complete follow-up data and were included in our analyses. EUC was defined as zero pad use and social urinary continence (SUC) was defined as ≤ 1 pad/24-h period at 3 months following surgery. Patient demographics and clinical factors such as age, body mass index (BMI), neurovascular bundle (NVB) sparing, RS-RARP operative technique and operating surgeon (consultant, trainee) were recorded. Median age was 64.0 years (IQR 57.0-69.0 years) with a median BMI of 27.0 (IQR 25.0-29.9). RS-RARP accounted for 59 of the 431 (13.7%) patients. 196 (45.5%), 142 (32.9%) and 86 (20.0%) received a bilateral, unilateral and nil NVB sparing, respectively. EUC was achieved by 241 patients (55.9%) and SUC was achieved in 339 (78.7%) patients. Multivariable logistic regression analysis suggests younger age (HR 1.04, 95% CI 1.01-1.07, p = 0.014) and RS-RARP technique (HR 2.19, 95% CI 1.15-4.16, p = 0.017) were independently associated with EUC at 3 months even after adjusting for BMI, external membranous urethral length and NVB sparing. Our results suggest that RS-RARP technique is independently predictive of EUC even after accounting for confounding factors. These findings should be further validated in a prospective or randomised trial.

Inhibition of LIM kinase reduces contraction and proliferation in bladder smooth muscle

Overactive bladder (OAB) is the most bothersome symptom in lower urinary tract symptoms (LUTS). Current pharmacologic treatment aims to inhibit detrusor contraction; however, shows unsatisfied efficacy and high discontinuation rate. LIM kinases (LIMKs) promote smooth muscle contraction in the prostate; however, their function in the bladder smooth muscle remains unclear. Here, we studied effects of the LIMK inhibitors on bladder smooth muscle contraction and proliferation both

Studies on the enzymatic synthesis of a new PPT-type ginsenoside via UDP-glycosyltransferase PgUGT74AE2 from Panax ginseng / 药学学报

UDP-glycosyltransferase PgUGT74AE2 from Panax ginseng can transfer a glucose moiety to the free C-3 hydroxyl of protopanaxadiol (PPD) to produce ginsenoside Rh2. However, no report demonstrates that PgUGT74AE2 can transfer a glucose moiety to the free C-3 hydroxyl of protopanaxatriol (PPT) to produce a PPT-type ginsenoside. In this study, the expression plasmid pET-32a-PgUGT74AE2 was constructed for expression of the recombinant protein and transferred into Escherichia coli Transetta (DE3) to generate the recombinant strain Transetta-PgUGT74AE2. The recombinant enzyme PgUGT74AE2 was expressed by induction of isopropyl-β-D-thiogalactoside (IPTG). An in vitro enzymatic reaction system was established with the recombinant enzyme PgUGT74AE2 and the substrate PPT. PgUGT74AE2 catalyzed the glycosylation of the free C-3 hydroxyl of PPT to produce 3-O-β-D-glucopyranosyl-dammar-24-ene-3β,6α,12β,20S-tetraol, a new PPT-type ginsenoside. This study provides an efficient approach for the biosynthesis of a new PPT-type ginsenoside through in vitro enzymatic reaction, which may pave a way to produce promising lead in drug discovery.

Imaging features of urinary dysfunction associated with ketamine abuse / 南方医科大学学报

<p><b>OBJECTIVE</b>To summarize the imaging features of urinary dysfunction associated with ketamine abuse (KAUD) for imaging diagnosis of KAUD.</p><p><b>METHODS</b>We analyzed the imaging findings in 45 patients with KAUD, all having a history of ketamine abuse and presenting with severe lower urinary tract symptoms. The patients underwent imaging examinations with ultrasonography (n=45), X-ray (n=38), computed tomography (n=28), magnetic resonance imaging (n=10) or single photon emission computed tomography (n=25), and the results were classified and evaluated to identify the common imaging findings.</p><p><b>RESULTS</b>The imaging changes of KAUD were found primarily in the urinary and biliary system. The most common imaging characteristics included thickening of the bladder wall, contracture and decreased functional volume of the bladder, dilation of the ureter and hydronephrosis, stricture of the upper ureter, renal impairment, dilation of the biliary system, and inflammation or swelling of the adjacent organs and lymph nodes</p><p><b>CONCLUSION</b>KAUD presents with typical imaging changes. Radiologists should be aware of KAUD if the typical imaging features are detected, especially in cases with a history of ketamine abuse.</p>

A model for predicting the success rate of a single extracorporeal shock wave lithotripsy session for single renal calculus / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the factors affecting the efficacy of extracorporeal shock wave lithotripsy (ESWL) and establish a model for predicting the success rate of a single ESWL session in the treatment of single renal calculus.</p><p><b>METHODS</b>Between January 2008 and February 2010, 325 patients underwent ESWL monotherapy and were followed up for at most 3 months. The correlations between the outcome of a single ESWL session and the patients' age, gender, body mass index (BMI), disease duration, pretreatment renal colic, hematuria, urinary irritation symptoms, stone location, stone laterality, stone length and stone width were analyzed. The statistically significant factors identifies were further analyzed by multivariate logistic regression, and the predictive model was established.</p><p><b>RESULTS</b>The stone-free rate of ESWL was 76.9%. Univariate analysis found that the patients' age, stone laterality, stone location, disease duration, pretreatment hematuria, stone length and width all significantly affected the outcome of the treatment. Logistic regression analysis indicated the factors including disease duration, pretreatment hematuria, stone length and stone width determined the success rate of the treatment. Hosmer and Lemeshow Test showed a good fitting of the predictive model (Χ(2)=18.144, df=8, P=0.168) with an overall accuracy of 87.4%.</p><p><b>CONCLUSION</b>Disease duration, pretreatment hematuria, stone length and width are independent factors affecting the outcome of a single ESWL session for single renal calculus.</p>

Clinical value of urinary potassium measurement in ketamine-associated cystitis / 中华泌尿外科杂志

Objective To investigate the relationship of 24 h urinary potassium (K) measurement and the symptoms change in ketamine-associated cystitis.Methods Forty-three ketamine-associated cystitis patients (29 male cases,14 female cases) were analyzed.The average age was 22 (17-29) years.Thirty-two patients without indwelling urinary catheter were categorized as group A,while the other 11 patients with indwelling urinary catheter were in group B.The therapy regimes consisted of anti-inflammatory,antioxidant,relieving spasm and pain,improving the microcirculation and repairing the bladder epithelium barrier.Thirty healthy adults were selected as the controls.Urinary K,sodium (Na) and creatinine (Cr)were determined in 24 h urine samples from all patients and controls before and after treatments.24 h urinary Cr was used as the internal standard.24 h urinary K and Na concentrations of the patients were calculated as relative to the Cr concentrations.The pelvic pain and urgency/frequency symptom (PUF) was used for evaluation before and after the treatments.The differences of urinary K were compared within each group and between groups before and after treatments.In addition,relationship of urinary K and PUF were assessed.Results Urinary Cr concentrations in all groups were not significantly different (P ＞ 0.05).Patients in group A had lower average K-to-Cr ratios than those patients in group B and controls (A 1.80 ± 0.67 vs.B 6.22±0.92 mmolK/mmol Cr,P=0.0001; A 1.80±0.67 vs.controls 6.47 ±0.97 mmol K/mmol Cr,P =0.0001) before treatments.But the ratios of K-to-Cr in group A were not significantly different with group B and controls after treatments (A 6.23 ± 1.42 vs.B 6.02 ± 0.98 mmol K/mmol Cr,A 6.23 ± 1.42vs.controls 6.47 ±0.97 mmol K/mmol Cr,F =0.698,P =0.472).PUF in both groups was not significantly different before treatments.For group A,PUF was negatively correlated with urinary K before and after treatments (before: r=-0.637,P=0.0001; after: r=-0.427,P=0.015).For group B,PUF had no correlation with urinary K before treatment (r=0.581,P =0.188),while there was a negative correlation between them after treatments (r =-0.779,P =0.005).PUF scores in all patients (group A + B)were significantly decreased after treatments when compared to those before treatments (18.12 ± 2.83 vs.22.77 ± 3.63,P =0.0001).Conclusion Urinary potassium measurement may have a role in evaluating the disease status and efficacy of treatments of patients suffered from ketamine-associated cystitis.

Effects of hepatectomized rat serum on the transdifferentiation of adult rat bone marrow cells into hepatocyte-like cells / 中华肝脏病杂志

<p><b>OBJECTIVES</b>To study the effects of hepatectomized rat serum and hepatocyte growth factor (HGF) on the transdifferentiation of adult rat bone marrow stem cells (ABMSCs) into hepatic parenchymal cells.</p><p><b>METHODS</b>The serum was collected from the rats 24 hours after being subjected to subtotal hepatectomy. ABMSCs were collected and cultured in DMEM/F12 (1:1) containing the hepaetectomized rat serum or HGF. The differentiated hepatocyte-like cells were labeled with CM-DiI and administrated by tail vein injection into the isogeneic rats. The cultured and injected cells were both identified by immunocytochemistry and cultured cells were assayed using RT-PCR and Western blot.</p><p><b>RESULTS</b>Hepatectomized rat serum and HGF were demonstrated to have the effect of inducing transdifferentiation of ABMSCs into hepatocyte-like cells in vitro. The differentiated cells expressed albumin mRNA and albumin after 7 days++'s co-incubation. Albumin-expressing and CM-DiI positive hepatocyte-like cells were characterized in livers and spleens of the rats injected with the cultivated cells.</p><p><b>CONCLUSION</b>ABMSCs could transdifferentiate into hepatic parenchymal cells by hepatectomized rat serum or HGF.</p>