[Effect of functional acupoint electrical stimulation combined with tadalafil on erectile dysfunction in middle-aged and elderly patients].

OBJECTIVE: To investigate the application effect of functional acupoint electrical stimulation combined with tadara irregular administration in middle-aged and elderly patients with erectile dysfunction (ED), and to provide reference for clinical treatment. METHODS: A total of 40 middle-aged and elderly patients with ED admitted to the pelvic floor Center of our hospital from March 2021 to March 2023 were randomly divided into two groups with 20 cases in each group.The control group was treated with tadalafil regularly, and the observation group was treated with functional acupoint electrical stimulation on the basis of this treatment. The total course of treatment was 6 weeks.The clinical efficacy of the two groups was compared. The therapeutic efficacy was evaluated by the International Erectile Function Index (IIEF-5), penile hardness score (EHS), serum total testosterone (TT) level, sexual satisfaction scale (SS) and pelvic floor electromyography, and the occurrence of adverse events was recorded. RESULTS: The total effective rate of the observation group was significantly higher than that of the control group (90% vs 70%, P < 0.05). After 6 weeks of treatment, both groups showed improvements in IIEF-5, EHS, SS, and TT compared to before treatment (P < 0.01). However, the improvement in the observation group was significantly better than that in the control groupï¼»IIEF-5: (22.13±2.11) vs (19.69±2.04), EHS: (3.68±0.47) vs (2.89±0.60), SS: (77.41±7.59) vs (70.32±7.28), TT: (13.43±3.89) nmol/L vs (8.85±3.02) nmol/L, all P < 0.01ï¼½; There were no significant changes in pelvic floor muscle electromyography values in the control group before and after treatment (P > 0.05), while in the observation group, pelvic floor muscle electromyography values (PFMV) in the pre-resting phase, fast muscle (Type II muscle) phase, slow muscle (Type I muscle) phase, endurance testing phase, and post-resting phase all improved compared to before treatment and were superior to the control group (P < 0.05). CONCLUSION: Functional acupoint electrical stimulation combined with tadara irregular administration can improve the therapeutic effect of middle-aged and elderly patients with ED, improve pelvic floor function, safe and reliable.

[Effects of 1470 nm semiconductor laser vaporization of the prostate on erectile function and pelvic floor muscle strength in patients with benign prostatic hyperplasia].

OBJECTIVE: To study the effects of 1470 nm semiconductor laser enucleation of the prostate (SCLEP) and transurethral plasma electrotomy (TUPE) on erectile function and pelvic floor muscle strength in BPH patients. METHODS: We retrospectively analyzed the clinical data on 72 cases of BPH treated in our hospital from July 2017 to July 2019 by TUPE (group A, n = 36) or 1470 nm SCLEP (group B, n = 36). We observed and compared the postoperative penile erectile function, retrograde ejaculation and pelvic floor muscle strength between the two groups of patients. RESULTS: Compared with group A, group B showed a significantly higher IIEF-5 score (19.43 ± 1.61 vs 21.15 ± 1.32, P < 0.05) and pelvic floor muscle strength (electromyographic ï¼»EMGï¼½ value) during rapid contraction (36.36 ± 1.38 vs 43.53 ± 2.04, P < 0.05), continuous contraction (34.27 ± 1.63 vs 39.46 ± 1.48, P < 0.05) and endurance test (35.24 ± 1.57 vs 38.19 ± 1.67, P < 0.05), but lower incidence rates of ED and retrograde ejaculation. CONCLUSIONS: Compared with TUPE, 1470 nm SCLEP affects less the erectile function and pelvic floor muscle strength of BPH patients.

[Yun's modified pelvic floor exercise improves female sexual dysfunction].

Objective: To study the effect and safety of Yun's modified pelvic floor exercise (PFE) in the treatment of female sexual dysfunction (FSD). METHODS: We enrolled 80 FSD patients from the Outpatient Department of Shanghai Fifth People's Hospital from August 2018 to January 2021 and randomized them into an experimental (n = 40) and a control group (n = 40), the former treated by Yun's modified PFE and the latter by traditional PFE, both for 8 weeks. After 0, 4 and 8 weeks of treatment, we evaluated the clinical effect by comparing the female sexual function indexes (FSFI), including sexual desire, sexual arousal, vaginal lubrication, orgasm, sexual satisfaction and sexual intercourse pain, the male partners' sexual satisfaction, and the pelvic floor muscle strength between the two groups of patients. RESULTS: Thirty-four of the patients in the experimental group and 36 in the control completed the treatment. There were no statistically significant differences in the baseline data between the two groups (P > 0.05). The FSFIs were significantly improved in both the experimental and control groups after 4 and 8 weeks of treatment compared with the baseline (P < 0.05), even more significantly in the experimental than in the control group at 8 weeks (P < 0.05). The effectiveness rate was remarkably increased from 52.8% at 4 weeks to 72.2% at 8 weeks in the experimental group (P < 0.05) and from 29.4% to 44.1% in the control (P < 0.05), even more significantly in the former than in the latter group (P < 0.05). Statistically significant differences were found in muscle tone and type I muscle strength between the two groups at 8 weeks (P < 0.05) but not at 4 weeks (P > 0.05). Type II muscle strength and partners' satisfaction were markedly higher in the experimental than in the control group at 4 and 8 weeks (P < 0.05). No adverse events were observed in either of the two groups. CONCLUSIONS: Yun's modified pelvic floor exercise can improve the symptoms of female sexual dysfunction, more effective than the traditional pelvic floor muscle exercise, and with no serious adverse reactions.

[Clinical effect of a scrotal rapid recovery dressing device in the treatment of acute epididymitis].

OBJECTIVE: To study the protective effect of a scrotal rapid recovery dressing device, scrotal girdle, on the scrotum of the patient with acute epididymitis, so as to improve the prognosis and the patient's satisfaction. METHODS: A total of 120 patients with acute epididymitis were treated in our hospital from December 2018 to November 2019, 60 with the scrotal girdle plus local cold compress in addition to antibiotics administration (the scrotal girdle group) and the other 60 with antibiotics only (the control group), all for 6 days. Then, comparisons were made between the two groups of patients in the improvement of scrotal swelling, total effectiveness rate and the patients' satisfaction with therapeutic outcomes. RESULTS: After 6 days of treatment, the patients in the scrotal girdle group, compared with the controls, showed significantly lower scrotal swelling scores (1.01 ± 0.34 vs 1.38 ± 0.20, P < 0.05), a higher total effectiveness rate (83.33% vs 65%, P < 0.05) and higher satisfaction with the therapeutic outcomes (86.67% vs 56.67%, P < 0.05). CONCLUSIONS: For the treatment of acute epididymitis, the application of the scrotal girdle for protection can significantly relieve scrotal pain and discomfort, improve the therapeutic effect and patients' satisfaction, and enhance the patients' recovery and quality of life.

[Application value of a metamorphic mechanism-based special dressing system for patients after scrotal surgery].

OBJECTIVE: To investigate the application of a metamorphic mechanism-based special dressing system (MMDS) in improving the prognosis and comfort of the patient after scrotal surgery. METHODS: We included 48 cases of scrotal surgery using the traditional method for postoperative dressing from June 2017 to June 2018 (the control group) and another 48 cases employing MMDS postoperatively from July 2018 to June 2019 (the MMDS group). We observed the differences between the two groups of patients in the incidence of scrotal edema, pain score, hospitalization days, patients' satisfaction, and dressing time. RESULTS: The scrotal edema score showed no statistically significant difference between the MMDS and control groups at 24 hours after operation (P > 0.05) but remarkably lower in the former than in the latter group at 48 hours (1.42 ± 0.5 vs 2.27 ± 0.7, P < 0.05) and 72 hours postoperatively (1.35 ± 0.2 vs 2.25 ± 0.7, P < 0.05). The MMDS group, compared with the controls, also exhibited a lower pain score (2.2 ± 1.0 vs 3.4 ± 1.5, P < 0.05), shorter hospitalization time (ï¼»5.96 ± 1.2ï¼½ vs ï¼»9.13 ± 2.3ï¼½ d, P < 0.05) and higher satisfaction score (98.1 ± 1.6 vs 92.8 ± 2.8, P < 0.05), as well as shorter dressing time at 24, 48 and 72 hours after operation (P < 0.05). CONCLUSIONS: The metamorphic mechanism-based special dressing system is a safe, efficient, simple and feasible method for dressing after scrotal surgery, which can effectively promote recovery and improve the quality of life of the patients.

[Yun's optimized pelvic floor training therapy for idiopathic moderate overactive bladder with sexual dysfunction in young and middle-aged women].

OBJECTIVE: To explore the efficacy and safety of Yun's optimized pelvic floor training (OPFT) therapy for idiopathic moderate overactive bladder (OAB) with female sexual dysfunction (FSD) in young and middle-aged women. METHODS: Eighty 25－45 years old women with idiopathic moderate OAB companied by FSD were randomized into an experimental and a control group of equal number, the former treated by 6 weeks of Yun's OPFT therapy, followed by a 2-week washout period and then another 6 weeks of traditional pelvic floor muscle exercises (PFME), while the latter by 6 weeks of traditional PFME, followed by a 2-week washout period also and then another 6 weeks of Yun's OPFT. At 0, 6 and 14 weeks, we recorded the scores on overactive bladder symptoms (OABS), patient perception of bladder condition (PPBC), Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire-7 (IIQ-7), pelvic floor muscle strength, voided volume (VV), average urinary flow rate (Qavg), maximum urinary flow rate (Qmax) and postvoid residual urine volume (PVR), female sexual function index (FSFI), sexual satisfaction of the male partners and adverse events, and compared the parameters obtained between the two groups of patients. RESULTS: Thirty-eight of the patients in the experimental group and 29 controls completed the experiment. There were no statistically significant differences in the baseline data between the two groups (P > 0.05). After 6 and 14 weeks of treatment, the effectiveness rate was decreased from 71% to 58% in the experimental group, but increased from 45% to 72% in the control. Significant improvement was achieved in the experimental group in the OABS, PPBC, UDI-6 and IIQ-7 scores, pelvic floor muscle strength, VV, Qavg, Qmax, FSFI and sexual satisfaction of the male partners at 6 weeks as compared with the baseline (P < 0.05), and even more significant at 14 weeks than at 6 (P < 0.05), and so was it in the control group in the PPBC and IIQ-7 scores, VV, Qmax and sexual satisfaction of the male partners at 6 weeks (P < 0.05), and more significant in the OABS, PPBC, UDI-6 and IIQ-7 scores, pelvic floor muscle strength, FSFI and sexual satisfaction of the male partners at 14 than at 6 weeks (P < 0.05). The patients of the experimental group showed remarkably more improvement than the controls in the OABS, PPBC, UDI-6 and IIQ-7 scores, pelvic floor muscle strength, FSFI and sexual satisfaction of the male partners at 6 weeks (P < 0.05), while the control group exhibited significantly better improved OABS, PPBC, UDI-6 and IIQ-7 scores, pelvic floor muscle strength, VV, Qmax, PVR and FSFI than the experimental group at 14 weeks (P < 0.05). No serious adverse reactions were observed during the treatment. CONCLUSIONS: Yun's OPFT therapy can improve the symptoms of moderate OAB with FSD in young and middle-aged women, with significantly better effects than traditional pelvic floor muscle exercises.

[Cloning of Guamerin gene in Whitmania pigra and its spatio-temporal expression analysis after ingestion].

The present study cloned wpGuamerin gene from a non-bloodsucking leech (Whitmania pigra), and the bioinformatics analysis of the sequence was performed. Additionally, the effects of feeding duration on the expression profile of the wp Guamerin gene were explored. The results showed that its sequence consisted of 295 nucleotides encoding a peptide of 83 amino acids(Genbank: KX768545), and its relative molecular weight is 9 145.95 Da. wp Guamerin does not encode proteins with a signal peptide, belonging to the hydrophilic protein. Its secondary structure is mainly composed of α-helix, extending chain, folding and random curl. Its similarity with other blood-sucking leeches ranges from 29% to 65%. The results revealed that wpGuamerin mRNA was detected higher expression in muscle than in salivary glands of Wh. pigra, and did not expressed in ingluvies and intestine. Its expression in muscle and salivary glands showed a single peak curve after feeding and the peak was observed in the 1st and 3rd after feeding, respectively. In summary, wp Guamerin in Wh. pigra is a small molecule polypeptide protein and is different from the Guamerin in blood-sucking leeches. wpGuamerin does not express in the digestive tract of Wh. pigra, and mainly express in muscle. Feeding behavior would stimulate the expression of wpGuamerin gene in muscle and salivary glands, but not in digestive tract.

[Effect of Astragali Radix on growth, immunity and related gene expression of Whitmania pigra].

To explore the effect and mechanism of Astragali Radix on growth and immunity of Whitmania pigra, 0, 0.01%, 0.03%, 0.05%, 0.07%, 0.09% of Astragali Radix were added to the daily feeding of Wh. pigra. After 60 days of feeding, the growth performance, activities of digestive enzyme and anti-reverse enzyme, inner quality, the expression levels of GH, IGF-1 and digestive enzyme-related genes were measured. Meanwhile, the effects of heat stress on the living conditions of Wh. pigra were observed and counted, and the expression levels of HSP70 and immune related genes were measured. The results showed that the final weight, weight gain rate, specific growth rate, activities of digestive enzyme and anti-reverse enzyme, the expression levels of GH, IGF-1 and digestive enzyme-related genes in the Astragali Radix group were higher than those in the control group, and with the increase of Astragali Radix concentration, the above-mentioned indexes increased initially and then decreased, and significantly higher in the 0.05% of Astragali Radix group than in the other groups (P<0.05). There was no significant difference in the inner quality of Wh. pigra between the Astragali Radix and control groups. The survival rate of Wh. pigra was negatively correlated with heat stress treatment duration. With the prolongation of heat stress treatment duration, the expression levels of HSP70 and immune related genes were increased first and then decreased, and peaked at 24 h. The survival rate and the expression levels of HSP70 and immune related genes in the Astragali Radix group were higher than those in the control group, and was significantly higher in the 0.05% of Astragali Radix group than in the other groups (P<0.05). In conclusion, Astragali Radix can increase the activities of digestive enzyme and anti-reverse enzyme, the expression levels of related genes, growth performance, and immunity to heat stress of Wh. pigra. It is suggested to add 0.05% of Astragali Radix in the actual production of Wh. pigra to improve the production profit.

[Different arousal modes of hibernating Whitmania pigra].

To study the suitable arousal modes of hibernating Whitmania pigra, the biological characteristics, activity of amylase, lipase, and protease as well as morphologic structure of digestive tract were investigated by direct observational method and 3, 5-dinitrosalicylic acid colorimetry, p-nitrophenyl palmitate ester（p-NPP）colorimetry, folin-phenol and histological methods. The results revealed that Wh. pigra activity was increased with increases of the water temperature and prolonging treating duration. Except for the feeding groups of direct arousal mode at 24 h and 48 h, none of the other Wh. pigra groups died. Compared with that of normal groups, the digestive tract structure of hibernating Wh. pigra was looser and the mucosal folds of craw were more sparse. No obvious recovery was observed for the structure of the digestive tract before 48 h of direct arousal mode or the 5th day of 15 °C gradient arousal mode. The mucosal folds of craw increased and the muscularis were incrassated after 72 h of direct arousal mode or the 8th day of 20 °C gradient arousal mode, that indicated the tissue structure was approximately restored to the normal state. The digestive enzyme activities were increased with prolonging treating duration. And the feeding groups recovered faster than that of the no feeding groups. Additionally, the enzyme activities of feeding groups were significantly higher than that of no feeding groups (P<0.05) and approximately restored to the normal level after 48 h in the direct arousal mode or 20 °C in the gradient arousal mode. In conclusion, both of the two modes can be applied to the arouse of hibernating Wh. pigra, and it should be fed when the temperature is recovered to 15 °C or 20 °C at 2 °C·d⁻¹ in the gradient arousal mode after 72 h in the direct arousal mode to reduce the death ratio and improve effectively the economic profit of Wh. pigra aquaculture.

[Preliminary study on pathogen of Whitmania pigra disease in high temperature environment].

In this paper, on the contrast of healthy leech, the bacterial diversities were analyzed by 16S rDNA sequence analysis of the bacteria of muscle and intestinal tract of Whitmania pigra, the environment water and sediment of cultivating the diseased Wh. pigra in high temperature by high-throughput sequencing to determine the possible pathogenic bacteria of bacterial diseases of Leech in high temperature. The results showed that the original sequence reached over 83 000, and the effective sequences accounted for more than 87%. The GC contents ranged from 52% to 54% and the bacterial diversities were abundant. Bacterial relative abundance analysis showed that the bacterial content of Proteobacteria, Bacteroidetes, and Firmicutes was the most abundant in all treatments. Compared with healthy leech muscles and intestines, the muscle and intestinal tract of pathogenic leech relative abundance of Bacteroides, Pseudomonas, and Desulfovibrio was significantly increased, and it was abundant in water and sediment of diseased leeches, Lead to the possibility that the pathogenic bacteria of this bacterial disease may be Bacteroides, Pseudomonas, Desulfovibrio.

[Effects of Cu²âº enrichment and release on growth， internal quality and relative gene expression of Whitmania pigra].

The present study explored the effects of Cu²âºenrichment and release on the growth and internal quality of Whitmania pigra, and the regularity of enrichment and release in different tissues of Wh. pigra. In the range of safe concentration(SC), a certain concentration of Cu²âº was added to the Wh. pigra for 50 days, and stopped adding for another 50 days. The growth index of Wh. pigra, Cu²âº content in different tissues, and the internal quality were determined. The results showed that the average body weight of Wh. pigra in 0.014 mg·L⁻¹ of Cu²âº group was significantly higher than that in control group during the experimental period (P<0.05), and the mortality rate was lower than that in the control group. The specific growth rate, digestive enzyme activity, growth and digestive enzyme related gene expression of Wh. pigra in Cu²âº group were significantly higher than that in the control group (P<0.05) during the early 40 days of enrichment, and there was no significant difference in the release period. In Cu²âº group, the expression of immune enzyme and immune enzyme related gene of Wh. pigra increased first and then decreased compared with control group (P<0.05). The ability of enriched Cu²âº in different tissues of Wh. pigra was digestive tract>muscle>skin. The ability of release Cu²âº was muscle>digestive tract>skin. There was no significant difference in the internal quality and hirudin gene expression between Cu²âº group and control group. In conclusion, Cu²âº can improve the expression of digestive enzymes, immune enzyme and related genes of Wh. pigra, promote the growth of Wh. pigra and enhance their immunity, but it doesn't affect the internal quality of Wh. pigra. The Wh. pigra can completely release Cu²âº within 30 days.

[Effect of ingestion on antithrombin activity in different tissues of Whitmania pigra].

To study the effects of ingestion on antithrombin activities in different tissues of Whitmania pigra, the salivary glands, ingluvies, intestine and muscle of adult leeches were weighted on the 1st d, 3rd d, 5th d, 7th d and 11th d after feeding, respectively, and meanwhile antithrombin activity was measured by antithrombin titration method. The results showed that the antithrombin activity of salivary glands in different stages was significantly higher than that in other tissues (P<0.05). The activity of antithrombin in muscle tissue increased initially and then decreased with the prolongation of the time after feeding, and the peak was observed on the 5th day after feeding (P<0.05). The activity of antithrombin in the salivary glands, gluvies and intestine were found the highest on the 1st day after feeding(P<0.05), and then gradually decreased with the prolongation of the time of stopping the diet. The total amount of antithrombin activity on the 5th day was increased by 49.5%, 73.5%, 69.1% and 126.0% comparing with the 1st, 3rd, 7th and 11th day after feeding, respectively (P<0.05). In summary, both the feeding behavior and the food can induce the secretion of anticoagulant substances in the salivary glands and the digestive tract. The total amount of antithrombin activity was the highest on the 5th day after feeding and the 5th day after feeding was suggested as harvesting time.

Adipose-derived stem cells seeded on polyglycolic acid for the treatment of stress urinary incontinence.

PURPOSE: To evaluate the effect and possible mechanism of suburethral tissue-engineered sling in an animal model of stress urinary incontinence (SUI). METHODS: Adipose-derived stem cells (ADSCs) were obtained from the adipose tissues of rats. The differentiation potential, proliferation, and viability of rat ADSCs were evaluated after infecting these cells with a lentiviral vector-encoding green fluorescent protein (GFP). Next, GFP transfected ADSCs were seeded on polyglycolic acid (PGA) fibers to construct the tissue-engineered sling with the induction of 5-azacytidine (5-Aza). Afterward, the tissue-engineered slings were transplanted into a rat model of SUI that was established by vaginal balloon dilatation method and bilateral ovariectomy. Histology and the leak point pressure measurements were performed at 2 months after tissue-engineered sling implantation. RESULTS: The ADSCs were found to be efficiently transfected with GFP, without any effects on proliferation, cell cycle and multi-differentiation potential. After been seeded on PGA fibers, ADSCs formed tissue-engineered slings in 4 weeks of induction culture. Two months after implantation, the mean leak point pressure (LPP) was significantly increased in sling-treated rats compared with the balloon-injured ovariectomized rats. Immunofluorescence assay showed that some of the GFP expressing cells stained positive for muscle-specific markers. CONCLUSIONS: The newly suburethral tissue-engineered sling restores LPP in the rat model of SUI, which could be an effective treatment in future SUI therapy.

[Studies on hibernation pivotal temperature of Whitmania pigra].

The biological characteristics, oxygen consumption, oxygen consumption rate, and activities of amylase, lipase and protease of Whitmania pigra at different temperature were studied by using direct observational method, the still water method and 3, 5-dinitrosalicylic acid colorimetry, right-nitrophenyl palmitate ester（ρ-NPP）colorimetry and folin-phenol method.The results revealed that with decreasing water temperature, the daily activity and the daily feeding ration were decreased. As the temperature was lowered to 4 ℃, the head and tail of Wh.pigra curved, showing a crescent-shape without feeding and daily activity. Oxygen consumption, oxygen consumption rate and digestive enzyme activities reduced along with temperature drops. The downward trend slowed below 10 ℃, began to stabilize below 4 ℃ and doesn't change with the decrease of temperature since then. During the 40 days treatment at 4 ℃, the changes of amylase were not significant, the lipase and protease activity decreased at the 20th day, and the lipase showed an slightly increase after the decrease and finally remained at a low level.In conclusions, the pivotal temperature of hibernation of Wh.pigra is 4 ℃ and the crescent shape can be considered as a symbol of hibernation.

[Treatment of castration-resistant prostate cancer: Evidence-based clinical practice].

OBJECTIVE: To introduce the framework of evidence-based practice with a case of castration-resistant prostate cancer (CRPC) as an example. METHODS: A clinical question was formulated according the clinical scenario. A systematic search was conducted for the published literature in the databases of PubMed, EMBASE, Cochrane Library, Clinical Trial Registries, and Web of Knowledge up to Dec 2014. The identified literature was reviewed for quality appraisal before the evidence was applied to clinical practice. RESULTS: The treatment was effective and the patient achieved disease remission. CONCLUSION: Evidence-based practice should be integrated with clinical scenario, current evidence, and patients' willingness, and follow a systematic framework.

Involvement of VKORC1 in the inhibition of calcium oxalate crystal formation in HK-2 cells.

The vitamin K epoxide reductase complex subunit 1 (VKORC1), the rate-limiting enzyme for vitamin K recycling, is significantly down-regulated in the kidneys of urolithiasis patients. This study searched for direct evidence to define the inhibitory activity of VKORC1 against calcium oxalate (CaOx) crystal formation. In the experiment of VKORC1 overexpression, HK-2 cells were transfected with the pFLAG-CMV-7.1-VKORC1 plasmid as a pFLAG-CMV-7.1-VKORC1 transfection group or the pFLAG-CMV-7.1 plasmid as a pFLAG-CMV-7.1 control group. In the experiment of VKORC1 knockdown, HK-2 cells were transfected with the PGPU6/GFP/Neo-VKORC1shRNA-2 as a PGPU6/GFP/Neo-VKORC1shRNA-2 transfection group or the PGPU6/GFP/Neo-shRNA-NC plasmid as a PGPU6/GFP/Neo-shRNA-NC control group. The expression of VKORC1 in HK-2 cells was detected by real-time quantitative PCR and Western blotting. The CaOx crystal formation was observed under the laser-scanning confocal microscope. It was found that the expression levels of VKORC1 mRNA and protein were significantly higher in the pFLAG-CMV-7.1-VKORC1 transfection group than in the pFLAG-CMV-7.1 control group (P<0.01). The number of CaOx crystals in HK-2 cells incubated in fluorescently labeled CaOx monohydrate (COM) crystal medium for 48 h was 14±4 per field (100×) in the pFLAG-CMV-7.1-VKORC1 transfection group and 26±5 per field (100×) in the pFLAG-CMV-7.1 control group respectively under the laser-scanning confocal microscope. The amount of CaOx crystal aggregation and formation in the pFLAG-CMV-7.1-VKORC1 transfection group was significantly reduced as compared with the pFLAG-CMV-7.1 control group (P<0.05). The expression levels of VKORC1 mRNA and protein were significantly lower in the PGPU6/GFP/Neo-VKORC1shRNA-2 transfection group than in the PGPU6/GFP/Neo-shRNA-NC control group (P<0.05). The number of CaOx crystals in HK-2 cells incubated in fluorescently labeled COM crystal medium was 65±11 per field (100×) in the PGPU6/GFP/Neo-VKORC1shRNA-2 transfection group and 24±6 per field (100×) in the PGPU6/GFP/Neo-shRNA-NC control group respectively under the laser-scanning confocal microscope. The amount of CaOx crystal aggregation and formation in the PGPU6/GFP/Neo-VKORC1shRNA-2 transfection group was significantly increased as compared with the PGPU6/GFP/Neo-shRNA-NC control group (P<0.05). These findings suggested that the VKORC1 protein could inhibit CaOx salt crystallization, adhesion and aggregation. This research would help us to understand the mechanisms involving the interaction between crystallization and epithelial cells and the formation of CaOx.

[Cardura monotherapy versus combination therapy of cardura and tolterodine L-tartrate tablets for II° ? benign prostatic hyperplasia with overactive bladder].

OBJECTIVE: To evaluate the effectiveness of the monotherapy of Cardura and the combination therapy of Cardura and Tolterodine L-Tartrate Tablets for II° ? benign prostate hyperplasia (BPH) with overactive bladder (OAB). METHODS: This study included 87 cases of BPH with OAB, with a disease course > or = 3 months, daily urination > or = 8 times, nocturnal urination > or = 2 times, urine volume < 200 ml per time, International Prostate Symptom Score (IPSS) > or = 8, OAB symptom score (OABS) > or = 3, quality of life score (QOL) > or = 3, post-void residual (PVR) < or = 100 ml, maximum urinary flow (Qmax) > or = 5 ml/s, prostate weight 25-50 g, and PSA < 4 microg/L. We randomized the patients to a monotherapy group (n = 44) and combination group (n = 43), the former treated with Cardura 4 mg qd, and the latter with Cardura 4 mg + Tolterodine L-Tartrate Tablets 4 mg qd, both for 8 weeks. Then we recorded the IPSS, OABS, Qmax, PVR, PSA, and adverse events. RESULTS: The baseline parameters showed no significant differences between the two groups (P > 0.05). In comparison with the baseline, both the monotherapy group and the combination therapy group showed significant decreased in the IPSS (16.50 +/- 4.27 vs 13.68 +/- 3.69 and 15.51 +/- 3.80 vs 11.49 +/- 2.75), urine storage symptom score (10.48 +/- 2.75 vs 7.98 +/- 2.34 and 9.47 +/- 2.31 vs 5.74 +/- 1.66), OABS (8.55 +/- 2.69 vs 6.32 +/- 1.97 and 8.21 +/- 2.55 vs 4.44 +/- 1.62), urgent micturition score (4.25 +/- 1.06 vs 3.23 +/- 0.99 and 4.07 +/- 0.83 vs 2.26 +/- 1.05), QOL (5.36 +/- 0.72 vs 3.43 +/- 0.66 and 5.07 +/- 0.86 vs 2.37 +/- 0.76) and PVR ([44.55 +/- 22.39] vs [38.30 +/- 20.20] ml and [36.19 +/- 21.21] vs [24.98 +/- 17.60] ml) (P < 0.01). All the six parameters were significantly more improved in the combination therapy group than in the monotherapy group (P < 0.01), but there were no remarkable differences between the groups in Qmax and voiding symptom score (P > 0.05). Neither group exhibited significant changes in the PSA level and prostate weight after treatment as compared with the baseline (P > 0.05). No acute urinary retention and other severe adverse reactions were observed during the medication. CONCLUSION: Both Cardura monotherapy and the combination therapy of Cardura + Tolterodine L-Tartrate Tablets can improve II ? BPH with OAB, and the latter has an even better efficacy than the former.

[Clinical trial of sexual dysfunctions in male patients with pituitary adenomas].

OBJECTIVE: To explore the clinical features and related factors of sexual dysfunctions in male patients with pituitary adenomas. METHODS: The questionnaires of sexual functions were collected from 86 male patients with pituitary adenomas. We examined the clinical features of sexual dysfunctions and analyzed the correlations between sexual behaviors and age, tumor type, invasiveness, tumor size, serum levels of prolactin (PRL) and testosterone. RESULTS: The incidence of sexual dysfunctions was 80.2% (69/86). Sexual dysfunctions were found in 84.6% (66/78) of the patients with functioning pituitary adenomas and 37.5% (3/8) of those with non-functioning pituitary adenoma respectively. In the PRL group, the incidence of erectile dysfunctions was 92.1% (35/38) and it was higher than those in the FSH (follicle-stimulating hormone) and GH (growth hormone) groups (P < 0.05). In the FSH group, the incidence of reduced sexual desire was 78.3% (18/23). In the GH group, the incidence of erectile dysfunctions was 70.6% (12/17) and the incidence of reduced sexual desire or ejaculation dysfunction was lower than that of the PRL/FSH group (P < 0.05). CONCLUSION: The incidence of sexual dysfunctions is quite high in males with pituitary adenomas, especially for those with functioning pituitary adenomas. The clinical features of sexual dysfunctions vary in different types of functioning pituitary adenoma. The incidence of erectile dysfunctions is the highest in the PRL group. Pathological type of pituitary tumors is a major risk factor of sexual dysfunctions.

[Treatment of pyonephrosis with upper urinary tract calculi].

OBJECTIVE: To improve the treatment of pyonephrosis with upper urinary tract calculi (UTC). METHODS: A total of 49 UTC patients with pyonephrosis were selected at our hospital during May 2004 to February 2010. Among them, 22 cases were treated with transurethral ureteroscope lithotripsy followed by tube internal drainage while another 27 cases underwent percutaneous nephrolithotomy. RESULTS: No such complications as septicemia and septic shock occurred during the first stage of external and internal drainage. The bacteremic symptoms of chill or fever occurred in 3 cases during the second stage of percutaneous nephrolithotomy and pyelolithotomy/ureterolithotomy (11.1%). There were 3 cases of nephrectomy. A follow-up period of 3 months to 5.5 years showed that all 33 cases had a varying degree of recovered renal functions. And there was no nephrectomy. CONCLUSION: The keys to a successful surgical treatment of pyonephrosis with upper urinary tract calculi are early diagnosis, timely drainage and relief of obstruction. Ureteroscopic lithotripsy, double-J placement and percutaneous nephrostomy drainage are excellent for relieving obstruction. As a safe procedure with minor complications, it creates proper conditions for a second stage operation.