Bladder Acellular Matrix Grafts Seeded with Adipose-Derived Stem Cells and Incubated Intraperitoneally Promote the Regeneration of Bladder Smooth Muscle and Nerve in a Rat Model of Bladder Augmentation.

The objective of this study was to investigate the feasibility of bladder acellular matrix grafts (BAMGs) seeded with adipose-derived stem cells (ASCs) followed by intraperitoneal incubation for bladder reconstruction in a rat model of bladder augmentation, and to explore the underlying mechanism. Autologous CM-DiI-labeled ASC-seeded (experimental group) and unseeded (control group) BAMGs were incubated in the peritoneum of male rats for 2 weeks and then harvested for bladder augmentation. Histological analysis of the incubated BAMGs revealed numerous cells growing in homogeneous collagen bundles in both groups. In the control BAMGs, these cells were mesenchyme derived, while in the ASC-seeded BAMGs, myofibroblasts and mesothelial cells were found inside and on the surface of the scaffold, respectively. Immunofluorescence analysis demonstrated that some of the myofibroblasts were transdifferentiated from the ASCs after 2 weeks of intraperitoneal incubation. The greater bladder capacity was found in the experimental group than the control group both 4 and 14 weeks postoperatively. Histological analysis revealed that the entire urothelium regenerated well both in the experimental group and the control group without significant difference 4 weeks and 14 weeks postoperatively. From the quantitative data of immunohistochemical and immunofluorescence staining, the smooth muscle cells (SMCs) regenerated significantly better in the experimental group than the control group both 4 weeks and 14 weeks postoperatively. Also significantly more nerve cells were found in the experimental group 14 weeks postoperatively. At 4 weeks postoperatively, the immunofluorescence double staining revealed that some SMCs in the BAMG were transdifferentiated from the implanted ASCs, but no CM-DiI labeling of ASCs was detected 14 weeks postoperatively. Taken together, our results demonstrate that ASC-seeded and peritoneally incubated BAMGs promote not only the morphological regeneration of the bladder smooth muscle and nerve, but also the bladder capacity, which indicates their potential for bladder regeneration.

The application of S.T.O.N.E. nephrolithometry in pediatric patients with upper urinary tract calculi treated with mini-percutaneous nephrolithotomy.

The purpose of this study is to verify the applicability of S.T.O.N.E. nephrolithometry in pediatric patients. 103 cases of pediatric patients younger than 4 years old with upper urinary tract calculi treated with mini-percutaneous nephrolithotomy from January 2012 to March 2014 were retrospectively reviewed and evaluated using this scoring system. All procedures were performed under general anesthesia, using a 14-French nephroscope through a 16-French working access. All patients were divided into two groups according to the stages of the operations, Group A for one-stage operation and Group B for two-stage operation. 87 cases were male and 16 cases were female with the mean age of 26.5 months. The total operation time of group A was 45.89±5.43 min, and 54.62±5.58 min of group B (p=0.000). The hospitalization for group A and group B was 6.63±1.34 and 7.23±1.24 days, respectively (p=0.134). The total S.T.O.N.E. score was 5.93±0.67 for Group A, and 7.92±1.04 for Group B (p=0.000). On further dividing each group into low/moderate/high complexity according to the total score, more cases of low/moderate complexity in group A and more cases of moderate/high complexity in group B (χ2=38.096, p=0.000) were reported. Our data suggest that S.T.O.N.E. nephrolithometry is applicable in pediatric upper urinary tract calculi assessment and predictive for the complexity of the operation, hospitalization, and even complications after the operation. Yet modification may be necessary to make this scoring system more distinguishable for pediatric cases.

The application of stem cells in bladder repair of tissue engineering / 国际外科学杂志

In recent years,using stem cells to repair the bladder defect is a hot issue on the studies of bladder tissue engineering.They are ideal seed cells for bladder regeneration of tissue engineering depending on their self-renewal and multi-differentiation potential.In this paper,we give a review on the use of embryonic stem cells and adult stem cells as seed cells to repair the bladder defect by tissue engineering approach.

Terazosin treatment in BPH/LUTS: a prospective, randomized, multicenter study / 中华泌尿外科杂志

Objective To compare the efficacy and safety of 2 mg/d and 4 mg/d of terazosin in the treatment of benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS).Methods A total of 120 BPH patients were randomly divided into 2 groups receiving 2 mg or 4 mg terazosin per day for 2 months. Arterial blood pressure, International Prostatic Symptom Score (IPSS) and peak flow rate (Qmax) before and after treatment were compared while side effects were estimated. Results Forty-six patients receiving 2 mg and 54 patients receiving 4 mg terazosin completed this study. Patients' age and pre-treatment blood pressure, IPSS and Qmax had no difference between the 2 groups. The improvement of IPSS (including obstructive score, irritating score and total IPSS) and Qmax was significantly better in 4 mg group. The percentage of patients experiencing greater than 30% improvement in Qmax in the 4 mg treatment groups was significantly higher than that of the 2 mg group (46.3% vs 23.9%, P=0.02). Side effects were rare and mild in both groups.Conclusion The improvements of IPSS and Qmax are significantly greater in 4 mg treatment of terazosin than that of 2 mg with no obvious increase of side effects.

Analysis and management of complications caused by holmium laser ureterolithotripsy / 国际外科学杂志

Objective To study the the causes, management and preventive measures for complications of holmium laser ureterolithotripsy. Methods Three hundred and seven cases of uteteral calculi from Jan. 2006 to Jan. 2010 were reported (203 men and 104 women, age ranged from 18-83 years,mean age 51.6 years). One hundred thirty-three patients had calculi in the lower ureter,94 in the middle part and 80in the upper ureter. Results The overall comminution rate was 89.9% (276/307 cases). sixteen cases (5.2%) were followed by ESWL due to the shift of the stones to the renal pelvis. The operation failed in 9 cases(2.9%), 3 cases(1%) had perforation,and recoveried after open operation. Deep infection was found in 3(1%)cases,which recoveried after anti-infective therapy. Conclusions Holmium laser ureterolithotripsy is an effective method for treating ureteral calculi, with advantage of high efficiacy,safety and minimal invasion. To master the operating induction, to raise operating technique and to take correct measure could reduce complications effectually.