Detrusor intability is one of the most common micturation dysfunction diseases in clinic. Detrusor is a kind of excitable tissue. High excitability of detrusor plays a major role in the cause of DI. The increase in excitability is myogenic in DI, and it is not directly related to neurogenic factors. The transmembrane potential, ion channels and signal transmission between cells are the main factors in the production of cell excitability changes. It is worth to study the myogenic factors to explore the treatment of detrusor instability. Proper treatment of the primary diseases, depress the excitability and block the signal transmission would be effective therapeutic strategies.

The surgical technique of total bladder replacement orthotopic intestinal neobladder has already been a well accepted method for urinary tract reconstruction after cystectomy in woad wide medical center in past 20 yeas.In this review,the update advance and viewpoint in some critical aspects of patients selection,reflux prevention,upper tract safety,continence,oncology safety,specific complications and quality of life were evaluated in the orthotopic bladder replacement.It is possible that the orthotopic bladder replacement become a new gold standard in urinary diversion after radical cystectomy.

Objective To observe the effect of carvedilol and motoprolol on the weight of cardiac muscle in patients with hypertensive heart disease.Methods One hundred patients with hypertensive heart disease were divided into two groups by random number and treated with carvedilol(n =54) and motoprolol(n =46) respectively for 12 months.Data were recorded (left ventricular end-diastolic dimension (LVEDD),left ventricular end-systolic dimension (LVESD),left ventricular ejection fraction (LVEF),interventricular septal thickness (IVST),and left ventricular posterior wall thickness (LVPWT)) before and after the treatment.Left ventricular muscle mass(LVW),left ventricular mass index(LVWI) were calculated.Results After treatment,both groups improved with declined LVEDD (motoprolol group:(43.60 ± 4.43) mm vs.(46.70 ± 3.21) mm,t =18.143,P ＜ 0.01 ; carvedilol group:(42.50 ± 2.56) mm vs.(46.5 ± 3.18) mm,t =18.232,P ＜ 0.01),thinner IVST (motoprolol group:(9.68 ± 1.65) mm vs.(12.01 ± 1.56) mm,t =12.785,P ＜ 0.01 ; carvedilol group:(9.05 ± 1.04) mm vs.(11.59 ± 1.54) mm,t =7.865,P ＜ 0.01),and increased LVEF (motoprolol group:(52.89 ± 8.78)％ vs.(50.23 ± 7.88)％; carvedilol group:(54.65 ± 8.87％)％ vs.(50.22 ±7.89)％).In the carvedilol treatment group,LVMI significantly (t =4.987,P ＜ 0.01) declined from (133.75 ±25.89) g/m2 to (109.25 ± 22.53) g/m2.In the motoprolol treatment group,LVMI declined from (134.76 ± 25.87) g/m2 to (119.78 ± 23.65.53) g/m2 (t =5.689,P ＜ 0.01).After the treatment,each index of carvedilol group improved significantly compared with metoprolol group (P ＜ 0.05).Conclusion Both medications are able to reduce the weight of cardiac muscle of patients with hypertensive heart disease,and carvedilol is better than motoprolol.

Objective To investigate the expression changes of connexin 43 (Cx43) gene and the functional changes of the gap junction intercellular communication (GJIC) among cultured unstable detrusor cells and their roles in the development of detrusor instability (DI). Methods Forty healthy female Wistar rats were divided into two groups: DI group and normal control group. RT-PCR and Western blot techniques were employed to detect the expression of Cx 43 mRNA and protein in the cultured detrusor cells. Scrape loading dye transfer (SLDT) technique was used to monitor the GJIC among cultured detrusor cells. Results The expression of Cx43 mRNA and protein in DI group was much higher than that in normal control group (P

Objective To investigate the effect of L-type and T-type calcium channel blocker on detrusor autorhythmicity, contractility in order to elucidate the pathogenesis of detrusor instability (DI). Methods Animal models of bladder outlet obstruction (BOO) were established in 33 female SD rats and another 10 served as normal control. Six weeks later, the changes of detrusor autorhythmicity and contractility were examined by means of cystometry and the in vitro detrusor strip study. Results The incidence rate of DI was 75.9%. The detrusor autorhythmicity and contractility increased evidently after BOO (P

Objective To investigate the relationship between p38MAPK and astrocytes activation by detecting the changes of p38MAPK,TNF-?,NO and NOS in the substance P-induced activation of spinal cord astrocytes in vitro.Methods Astrocytes,cultured from spinal cord of SPF rat and identified by immunofluorescence method with GFAP antibody,were grouped into the control group,the SP stimulus group(SP group) and the SB203580 interrupt p38MAPK group(interrupt group) in which SP(10-7 mol/L) and SB203580(10 ?mol/L) were added to the supernatant for 12 h.The WB method,RT-PCR and ELISA were used to determine the changes of p38MAPK,phosphorylated p38MAPK,GFAP mRNA,TNF-?,NO and NOS in the astrocytes or supernatant at 1,3,12,24 and 36 h respectively.Results The GFAP positive rate of the cultured cells was higher than 95%.p38MAPK level in the SP group did not have any change,whereas p-p38 level increased significantly after 1 h and GFAP mRNA,NO,NOS and TNF-? level increased after 3 h.When p38MAPK pathway was inhibited by SB203580 in the SP+SB group,GFAP mRNA,NO,NOS and TNF-? were significantly reduced compared with those in the SP group.The level of p38MAPK,p-p38,GFAP mRNA,NO,NOS and TNF-? in the SB group did not have changes compared with those in the normal group.Conclusion These results indicate that p38MAPK signal pathway contributes to substance P induced activation of spinal cord astrocytes according to inflammatory factors attenuation after p38MAPK signal pathway interruption by SB203580.

Objective To investigate the expression of p38 mitogen-activated protein kinase(p38MAPK) in posterior horn of L5-S2 spinal cord in analgesia for chronic prostate pain with intrathecal injection of SB203580(p38MAPK inhibitor activity) in a murine model.Methods Forty-five male SPF SD rats were randomly divided into control group(n=5),prostatitis group(n=10) and SB203580 analgesia group(n=30,SB203580 was intrathecally injected).In the SB203580 analgesia group,complete Freund's adjuvant was injected into the prostate and SB203580 of 0.5?g/10?l,2.5?g/10?l and 12.5?g/10?l was intrathecally injected respectively.Five days and ten days after drug administration or simple modeling,phosphorylated p38MAPK(p-p38MAPK),glial fibrillary acidic protein(GFAP),tumor necrosis factor-?(TNF-?),nitric oxide(NO) level and induced nitric oxide synthase(iNOS) activity of L5-S2 spinal dorsal horn of rats were determined by Western blotting and ELISA assay,respectively.Results In the prostatitis group,the p-p38MAPK,GFAP,TNF-?,NO level and iNOS activity of L5-S2 spinal dorsal horn of rats at the 5th day and the 10th day were significantly higher than those of the control group and increased with time.The p-p38MAPK,GFAP,TNF-?,NO levels and iNOS activity at the 5th day and 10th day in SB203580 analgesia group were lower than those in the prostatitis group.Conclusion P38MAPK signaling pathway was involved in the mechanism of pain conduction and analgesia by SB203580 after prostatitis.The level of inflammatory factors in spinal cord can be effectively reduced by blocking the p38MAPK signaling pathway.

Objective · To clarify effect of adipose stem cells derived conditioned medium (ASCs-CM) on fibrogenesis of dermal fibroblasts costimulated by transforming growthfactor-β1 (TGF-β1), and explore the possible paracrine pathway of ASCs in regulating the dermal tissue rehabilitation.Methods · Co-stimulated by TGF-β1, dermal fibroblasts were treated with different concentrations of ASCs-CM. Variouscellular events including cell proliferation, apoptosis, and mRNA and (or) protein levels of α-smooth muscle actin (α-SMA), type Ⅰ collagen (COL-1) , type Ⅲ collagen (COL-3), hepatocyte growth factor (HGF), basic fibroblast growth factor (FGF-2) were explored. Furthermore, the effect of HGF antibody on apoptosis of fibroblasts caused by ASCs-CM and TGF-β1 were also observed. Results · ASCs-CM inhibited fibroblasts proliferation caused by TGF-β1 and lead to cell apoptosis. α-SMA expression in fibroblasts was attenuated by 10% ASCs-CM +TGF-β1. It was demonstrated that 100% ASCs-CM with TGF-β1 had promoted collagens (especially COL-3) expression in fibroblasts, and increased HGF mRNA level as well. HGF antibody inhibited fibroblasts apoptosis produced by 100% ASCs-CM and TGF-β1. Conclusion · ASCs may have an effect on fibrogenesis of dermal fibroblasts co-stimulated by TGF-β1 through a paracrine way.High concentration of ASCs-CM not only increases collagen production and secretion, but also inhibits fibroblasts proliferation and accelerates apoptosis.

Objective To study the status of coincidence of high-risk human papillomavirus(HR-HPV)test and thinprep cytolo-gy test with biopsy histopathologic diagnosis.And to investigate the value of combined detection in the diagnosis of the cervical cancer and precancerous lesions.Methods High-risk HPV test and thinprep cytology test were taken simultaneously in 1374 pa-tients visiting department of gynecological oncology.The diagnostic value of combination assay of these indices was evaluated.Re-sults In 684 patients with ASCUS pathology diagnosis,inflammation accounted for 5 1.3% and CINⅠ accounted for 47.4%.A-mong the 375 patients with LSIL pathology diagnosis,CINⅠ accounted for 48.5% and CIN Ⅱ-Ⅲ accounted for 21.3%.Among the 294 patients with HSIL pathological diagnosis,CIN accounted for 24.5%,and CIN Ⅱ-Ⅲ accounted for 62.9%.Among 20 pa-tients with SCC pathology diagnosis,CIN Ⅱ - Ⅲ accounted for 20% and cervical cancer accounted for 80%.Statistical analysis showed the difference of diagnostic results between thinprep cytology test and histopathologic diagnosis was statistically significant (P <0.05).The positive rate of high-risk HPV was 74.3%,and the negative rate was 25.7%.The positive rate of high-risk HPV significantly increased along with the rise of pathological level.The difference of pathologic diagnosis results between high-risk HPV positive group and negative group was statistically significant (P <0.05).When thinprep cytology test combined with high-risk HPV test,its sensitivity was 76.5%,and the specificity was 80.3%.The difference of the sensitivity between joint detection and thinprep cytology test was statistically significant (P <0.05).The difference of the specificity between joint detection and high-risk HPV test was statistically significant (P <0.05).Conclusion Combined thinprep cytology test and high-risk HPV test will improve the detection rate of cervical lesions and it is an ideal method to screen for cervical cancer.

The overall 5-year survival rate for patients with metastatic colorectal cancer(CRC) is less than 10%.Median survival with 5-fluorouracil(5-FU)/leucovorin(LV) therapy is approximately 12 months.Recent additions to the chemotherapy armamentarium for this disease have begun to prolong median survival times.In trials in which patients are exposed to all three approved chemotherapy agents,oxaliplatin,irinotecan,and 5-FU/LV,or capecitabine during the course of their disease,median survival has reached 20 months. The addition of oxaliplatin and irinotecan to 5-FU/LV regimens has also led to the maintenance of quality of life for longer intervals than were traditionally observed with 5-FU/LV alone.Current standard first-line regimens for metastatic CRC are FOLFOX(infusional 5-FU/LV with oxaliplatin) and FOLFIRI(infusional 5-FU/LV with irinotecan).Ongoing investigations will identify a place for molecular targeted combination chemotherapy on metastatic colorectal cancer(CRC) and some trials achieved better efficiency.In this review,we discuss the current advances in combined management of metastatic colorectal cancer of 5-Fu,chemotherapy,Molecular targeted therapy.