Objective To investigate the significance of Qmax and residual urine in evaluation of bladder function in the patients with benign prostatic hyperplasia (BPH).Methods The clinical data of 61 patients with BPH and 20 healthy persons in control group were evaluated.Bladder function,uroflowmetry and ultrasonic residual urine measurement were performed in the 2 groups.The correlation between Q max and residual urine in BPH group was investigated.Results There was significant difference in Qmax between the BPH group and control group (8 vs.21 ml/s,u=-6.090,P=0.007).There was significant difference in residual urine between the 2 groups (60 vs.9 ml,u =-6.718,P=0.005).And there was a negtive correlation between residual urine and Qmax in BPH group (r=-0.366,P=0.009).Conclusion It is useful to measure the Qmax and residual urine in evaluation of bladder function affected by bladder outlet obstruction caused by BPH.

Objective To investigate the causes,diagnosis and treatment of postoperative acute cholecystitis. Methods Clinical data of 9 cases with postoperaive acute cholecystitis were analyzed retrospectively. Results7 cases was confirmed by ultrasonography, 1 case was confirmed by CT, and 1 case died of gallbladder perforation, no operative mortality in emergency cholecystectomy. Conclusion The prevalent etiology is biliary stasis. Early diagnosis and treatment is the key point to decrease the death rate.

Objective To explore the role and significance of free radicle in the pathophsiological mechanisms of diabetic cystopathy(DCP).Methods The detrusor strip contraction experiments were performed and observed in the group of type 2 diabetes mellitus(T2DM) rats at different time stages and the control group.The bladder tissue samples was made into homogenate,and the activities of superoxide dismutase(SOD) and the contents of malondialdehyde(MDA) were determined.Results The minimum stretch forces to induce the detrusor contractions in T2DM group were larger than the control group.Compared with the control group,the detrusor contractive frequency was higher in the period of 0 to 16 weeks,but was lower after the 20th week.The maximum detrusor contractive forces in the T2DM group showed a descended tendency with the elapse of the experiment time.In the bladder homogenate of the control group,the activities of SOD was declined after reaching the peak at the stage of 8th week,and then escalated at the stage of 24th week.As for the T2DM group,the activities of SOD became higher in the 4th week,than descended at the stage of 8th and 24th weeks.The contents of MDA in both groups showed descended tendency.In T2DM group,MDA became even lower than the control group in the 4th week and became higher than the control group in the 8th week.The ratio of SOD/ MDA in T2DM group was lower than the control group.In details,the ratio of SOD/MDA in T2DM group rose significantly in the 4th week,while declined in the 8th week.There was a negative correlation between the maximum detrusor contractive force and detrusor contractive frequency,and a positive correlation between the maximum detrusor contractive force and the contents of MDA.Conclusion The destrusor functions are impaired by Diabetes Mellitus.In the initial stage of DCP,the bladder functions are normal,because the detrusor had a high ability to remove the free radicle.In the progression stage of DCP,the bladder functions become decompensation,because the organism is seriously injured by the free radicle.So the impairment by free radicle is one of important mechanisms of destrusor impairment of diabetic cystopathy.

Objective To evaluate the role of transurethral resection of the prostate(TURP)in early diagnosis of prostate carcinoma.Methods TURP were perforhaed on 16 suspected patients with prostate carcinoma,based on their mean serum PSA level(11.7 ng/ml),negative results of anal touch and needle system biopsies,or with lower urinary tract symptoms,or those biopsy was not fit.6 cases were diagnosed prostate carcinoma by pathology.3 cases underwent double orchieetomy and treated with anti-androgen drugs.2 cases were emasculated by medicines and treated with anti-androgen drugs.1 case underwent radical prostatectomy after neoadjuvant hormonal therapy.Results 6 cases(37.5%)diagnosed prostate carcinoma by pathology were followed up for 3 months to 2 years and were all alive.Lower urinary tract symptoms were relived in 2 patients who underwent TURP. Conclusion TURP play a important role in early diagnosis of prostate carcinoma in certain circumstances.The symptoms could be relieved by TURP in patients with lower urinary tract symptoms.

Objective To make certain about the phase of time from the culminated point of instantaneous accelerating wave intensity (W1) to that of instantaneous decelerating wave intensity (W2) wave intensity(WI) technique. Methods The ejection time of the curve of Doppler rate of flow in aortic opens and W1～W2 of common carotid arteries of both sides were detected in 66 healthy adults by Prosound α10 color Doppler ultrasound and the data were contrasted and analyzed. Results There were no statistical significances in the standardized value difference of ejection time of aorta and of time from starting point of W1 to culminated point of W2 in common carotid arteries of both sides (P>0.05). And there were all statistical significances in the standardized value difference of ejection time of aorta and of time in other groups (P<0. 001). Conclusions The ejection time is the time from starting point of W1 to culminated point of W2. The beginning of cardiac ejection should be the starting point of W1 curve,and the culminated point of W2 is the terminal time of ejection.

Objective To explore the generalization and application of R-W1 through the phase analysis of Wave intensity technique.Methods The phases of R-W1 of 66 healthy adults were detected by Aloka Prosound α10 color Doppler uhrasound.Results There were all statistical significances in the time difference of R-W1 in left and right common carotid arteries and right brachial artery(P＜0.01),in the pressure wave conductive time in left and right common carotid arteries(P＜0.05),in right brachial artery and both sides of common carotid arteries(P＜0.01).There were no statistical significances in the time from the starting point to the culminate point of W1 in left and right common carotid arteries.There were statistical significances in the time from the starting point to the culminate point of W1 in right brachial artery and both sides of common carotid arteries(P＜0.05).Conclusions"R-W1 almost equals to pre-ejection period"as reported by literatures actually involves three phases which respectively are isovolumetric contraction time of left ventricle,pressure wave conductive time and time from the starting point to the culminate point of W1.The factor of pressure wave conductive time should be considered when evaluating diseases in clinic.The pre-ejection time should be the time from the culminate point of R wave in ECG to the starting point of W1 and the time from the starting point to the culminate point of W1 should not be involved in.

Objective To evalute the clinical application of the new technique of instantaneous wave intensity(WI) through the correlative analysis of instantaneous acceleration wave intensity(W1) and Tei index. Methods The correlation of the intensity of W1 (the apogee of W1) and Tei index of 66 healthy adults were analyzed by Prosound a10 color Doppler ultrasonograph. Results There were positive correlations in pressure and caliber between the common carotid arteries of both sides in 66 cases of healthy adults (P <0.01). There were negative correlations respectively between the pressure of W1 of left and right common carotid arteries and Tei index (P <0.05),and there were the same in caliber (P <0.01), mean pressure (P <0.05) and mean caliber (P <0.01). Conclusions W1 is negatively correlated with Tei index and can be an index in judging the systolic function.

Objective: To assess the clinical effects of percutaneous electrical stimulation on refractory lower urinary tract symptoms in elderly female patients. Methods: Elderly female patients with refractory lower urinary tract symptoms from July 2016 to December 2017 were recruited.According to cystoscopy results, patients were divided into an interstitial cystitis group, a suspected interstitial cystitis group and an overactive bladder group.All patients received 3 courses of transcutaneous low-frequency electrical stimulation treatment in the suprapubic bladder area, with 40 min per time, 4 times per day, 7 days per course.Bladder diaries, pain scores and overactive bladder symptom scores were recorded before and after treatment. Results: A total of 27 patients with a mean age of 74.3 years were enrolled.Under the cystoscope with water dilatation, 9 cases were found to have mucosal bleeding, with mast cells detected in mucosal specimens examined via electron microscopy(in the interstitial cystitis group), 5 cases had superficial mucosal congestion(in the suspected interstitial cystitis group)and 13 cases showed normal imaging(in the overactive bladder group). In the interstitial cystitis group, the 24-h urinary frequency improved from 15.4±2.5 times before treatment to 11.9±2.0 times after treatment(P<0.05), but pain scores had no significant difference before and after treatment[(8.3±2.0) and (8.2±1.6), P>0.05]. In the suspected interstitial cystitis group, the 24-h urinary frequency improved from (11.8±1.5) times before treatment to (8.4±1.1) times after treatment, and pain scores decreased from (6.4±1.1) to (4.2±1.1)(P<0.05). In the overactive bladder group, the 24-h urinary frequency improved from (19.2±2.0) times before treatment to (15.9±1.3) times after treatment(P<0.05), and the overactive bladder symptom score(OABSS)decreased from (8.9±1.6) to (5.9±1.6)(P<0.05). Conclusions Percutaneous electrical stimulation is an easy, safe and effective treatment in elderly females with refractory lower urinary tract symptoms, and should be encouraged in clinical practice.

OBJECTIVETo analyze the value of the diagnostic criteria for bladder outlet obstruction in benign prostatic hyperplasia (BPH).

METHODSA total of 358 patients with BPH were divided into 3 grades according to fibrous urethrocystoscopy information on the severity of obstructions, which were classified as Grade 1 (slight), Grade 2 (moderate), and Grade 3 (severe). By Schäfer's graph they were divided into 7 grades, represented by 0 to VI. We analyzed the volume of prostate, maximum flow rate (Qmax), residual urine volume, International Prostatic Symptom Score (IPSS) and detrusor instability. Statistical analysis ANOVA (analysis of variance) was made, spearman correlation evaluated and the coefficient of determination measured.

RESULTSOf all the patients, 27 were classified as Grade 1, 236 as Grade 2 and 95 as Grade 3. Eighty-four patients had detrusor instability. The volumes of the prostate ranged from 16 ml to 145 ml, averaging (47.04 +/- 15.61) ml. The mean maximum flow rate was (10.02 +/- 2.12) ml/min and the mean residual urine volume was (84.06 +/- 36.50) ml. With the increase of the severity of obstruction, the volume of the prostate increased (F = 4.216, P < 0.05), IPSS rose (F = 8.408, P < 0.001), the maximum flow rate decreased (F = 22.43, P < 0.001), the residual urine volume rose (F = 163.232, P < 0.001), the incidence of detrusor instability increased (F = 23.637, P < 0.001) and Schäfer's grades were elevated (F = 202.897, P < 0.001). The volume of the prostate, the maximum flow rate (Qmax), residual urine volume, IPSS detrusor instability and Schäfer's grades were all correlated significantly with the severity of the obstruction. The correlation index and coefficient of determination were r = 0.29, R2 = 0.08; r = 0.35, R2 = 0.12; r = -0.69, R2 = 0.47; r = 0.60, R2 = 0.36; r = 0.33, R2 = 0.11; r = 0.72, R2 = 0.52; respectively. The correlation between the urethrocystoscopy information and Schäfer's graph on the severity of the obstruction were the best criteria of all.

CONCLUSIONThe severity of the obstruction at urethrocystoscopy correlates well with that at urodynamic investigation. Such criteria could improve the sensitivity and specificity of the diagnosis of bladder outlet obstruction.

Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia ; complications ; diagnosis ; Retrospective Studies ; Urinary Bladder Neck Obstruction ; diagnosis ; etiology ; Urodynamics