Objective To compare the outcomes of TOT and TVT procedure treating female intrinsic sphincter deficiency (ISD).Methods From May 2010 to September 2015,42 stress urinary incontinence (SUI) patients whose abdominal leak point pressure was less than 60 cmH2O were enrolled in this study.Thirty-five patients were followed up.The mean age was (56.8 ±10.5) years,with a range of 30-80 years.The mean history was(10.5 ± 9.1)years,with a range of 4 months to 30 years,with 26 (74.3％) of them being postmenopausal,5 (14.3％) having a history of pelvic surgery,and no pelvic organ prolapsed or hormone replacement.All of them were randomly divided into 2 groups to undergo either TVT operation (13 cases) or TOT operation (22 cases).The baseline characteristics of the two groups including age,length of history,urodynamic parameters and scale scores showed no significant difference.The scales including urinary incontinence severity score (UISS),detrusor instability score (DIS),Quality of Life Scale Evaluation (I-QOL),lower urinary tract symptoms affect score (UDI-6) were used.The outcomes between TVT group and TOT group were compared.Result After procedure,patients in TVT group got a lower UISS score than TOT group(17.2 ± 2.2 vs.17.7 ± 3.1),and their severity of urinary incontinence improved significantly (P ＜ 0.05).Patients from TVT group got a lower DIS score than TOT group (12.6 ± 4.2 vs.14.2 ± 3.5),and their detrusor instability symptoms improved more significantly (P ＜ 0.05).Patients from TVT group got a higher I-QOL score than TOT group(17.5 ± 14.5 vs.16.1 ± 13.0),and their quality of life improved more significantly (P ＜ 0.05).Patients from TVT group got a lower UDI-6 score than TOT group (10.1 ± 3.0 vs.11.2 ± 3.4),and their lower urinary tract symptoms improved more significantly (P ＜ 0.05).Conclusion Urinary incontinence of female ISD patients were improved greater by TVT than TOT procedure.

Objective To research and prepare the individualized knee in vitro guided plate by 3D printing technique and to investigate the feasibility of its application in 8-plate epiphysiodesis.Methods Twelve children patients with knee varus or valgum in our hospital from January 2014 and November 2016,7 boys and 5 girls,average age of 8.2 years old,were performed the lower extremity continuous spiral CT scanning in the knee straight position.The Dicom format stored CT data were imported into software Mimics 15.0 for reconstructing the knee joint 3D model.The knee joint data after reconstruction were guided into software Geomagic1 1.0 with the.stl format.According to the demand that screws without perforating epiphyseal and joint surface,paralle ling to the epiphyseal and locating in the anterior-posterior median line of epiphyseal,the 8-plate placing screw navigation template was designed and printed by using the 3D printing technique;the 8-plate plate and screw internal fixation was conducted by intraoperative template location.The placed screw position was evaluated by postoperative CT.Results The imaging identification showed that 8-plate epiphysiodesis by using 3D printing individualized in vitro guided plate had accurate screw placement.The cases were followed from 6 months to 2 years,the satisfactory orthopedic effect was obtained in all cases.Conclusion Preparing the individualized knee in vitro guided plate by applying 3D printing technique in assisted 8-plate epiphysiodesis for treating child knee varus or valgum has accurate screw position and satisfactory effect.

Objective To analyze the clinical value of ultrasound and ultrasound-guided core needle biopsy ( UNB) in the evaluation of axillary lymph node metastasis for breast cancer.Methods A total of 454 cases of breast cancer treated between June 2008 and August 2014 at our hospital were retrospectively analyzed.UNB was performed on patients with abnormal ultrasonic diagnosis of axillary lymph nodes.Among them, 354 cases underwent neoadjuvant chemotherapy or endocrine therapy while 100 cases underwent surgery after UNB.The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and false negative rate of ultrasound and UNB were evaluated.Results Among the 454 patients with abnormal axillary lymph nodes of ultrasound imaging, the metastasis rate with UNB was 70.9%,while the negative rate was 29.1%.Among the 100 cases who underwent surgery after UNB, the metastasis rate was 25% while the ultrasound imaging lymph node longitudinal and transversal ( L/T)≤1.5,the lymph node size>1 cm,and the metastasis rate was 92.3%(12/13).UNB showed that sensitivity was 64.1%, specificity 100%, accuracy 86%, positive predictive value 100%, negative predictive value 81.3%,and false negative rate was 18.7%.The results of UNB seemed consistent with those of postoperative pathological diagnosis, the Kappa value being 0.685.Based on 2 and 3 needles, the above mentioned 6 indices were 50% and 77.8%, 100% and 100%, 77.8% and 92.5%, 100% and 100%, 71.4% and 89.7%,and 28.6%and 10.3%, respectively.The Kappa value of UNB based on 3 needles was higher than on 2 needles (0.822 vs 0.526 ) .Conclusion Ultrasound is a valuable tool for detecting axillary lymph node metastasis in breast cancer.UNB can accurately determine the axillary lymph node metastasis status.UNB based on 3 needles shows a higher accuracy than on 2 needles.

Objective To compare the outcomes between interstitial cystitis/painful bladder syndrome (IC/PBS) patients treated with four-drug combination (heparin,lidocaine,sodium bicarbonate,gentamicin) and sodium hyaluronate intravesical instillation.Methods There were 23 IC/PBS patients from Jan.1,2011 to Mar.1,2013.Ten patients (group A) received four-drug combination (heparin 40 000 U,'gentamicin 160 000 U,sodium bicarbonate 1％,lidocaine 0.4％) instillation treatment.Thirteen patients received instillation of sodium hyaluronate (40 mg/50 ml) therapy (group B).In group B,intravesical instillations were performed weekly in the first 6-8 weeks,and monthly until one year.Patients in group A received intravesical instillation twice a week in the first 6-8 weeks and twice a month for 10 months.All the patients were instructed to retain the instillation volume for at least one hour.Clinical symptoms (24 h frequency of urination,maximal micturition volume),O'Leary-Sant symptom and problem index were assessed at baseline and 1,6 and 12 months after treatment.The 2 therapies were compared within curative effects and side effects.Results Twenty-two of the 23 patients were followed up to 12 months.Patients in group A had no adverse events reported.One case of group B dropped out from treatment for recurrent urinary tract infection,and the other two cases felt painful in bladder area during instillation.There was no significant difference in initial scores between the 2 groups (P＞0.05).At 1,6,12 months after intravesical instillation,interstitial cystitis symptom index,interstitial cystitis problem index,24 h frequency of urination,the maximum bladder capacity were improved in both groups.All indicators in group A and B were improved significantly after treatment compared with pretreatment (P ＜ 0.05).≥ 25％ decrease of interstitial cystitis symptom index or ≥25％ decrease of 24 h frequency of urination were defined as remission.Remission rates of the 2 groups at each time point were:1 month after treatment (100％ versus 100％,P=1.000),6 months after treatment (80％ versus 83％,P=1.000),1 year after treatment (70％ versus 75％,P=1.000).There were no significant differences between the 2 groups in all time points for the outcomes (P ＞ 0.05).Conclusion The four-drug combination intravesical instillation could achieve a similar effect with hyaluronic acid therapy in patients with IC/PBS.

[Objective]This study was designed to determine growth inhibition of diallyl trisulfide(DATS)in human prostate cancer cells by inducing apoptosis and further to investigate the mechanism underlying such effect.[Methods]Growth inhibition by DATS was estimated by the tetrazolium(MTr)assay.Apoptosis induction in DATS-treated cells was assessed by fluorescence microscopy analysis of cells with condensed and segmented nuclei following staining with DAPI and flow cytometric analysis of cells with sub-G1 DNA content following staining with propidium iodide.Protein levels of apoptosis regulating proteins were determined using western blot.The activity of caspase-3 was measured using a colorimetric assay.[Result]DATS showed tumor growth inhibition in a time-and dose-dependent manner,IC_(50) of DATS was 14 μmol/L at 72 h.DATS evoked apoptosis as confirmed by cell morphology and by the analysis of flow cytometry.The expression of Bcl-2 and Bcl-xL,the apoptosis-suppressing proteins,was more down-regulated.The activity of caspase-3 was enhanced by DATS.[Conclusion]DATS inhibits growth of prostate cancer cells by inducing apoptosis in association with down-regulation of Bcl-2 and Bcl-xL and activation of caspase-3.

Objective To assess the long-term outcome of transurethral resection of the prostate (TURP) in men with different maximum detrusor pressure (Pdet.max).Methods 113 neurologically intact men diagnosed with BPH and undergone surgical intervention in our department were enrolled between Feb.2009 and May 2012.All patients had completed the International Prostate Symptom Score (IPSS) and quality-of-life (QOL) questionnaires and had undergone a full urodynamic analysis before surgery.The outcomes were assessed at 24 months postoperatively using the IPSS score,QOL score,and maximum urinary flow rate (Qmax).Results After 24 months follow-up,3 cases in the poor symptom improvement group could not void.The average Pdet.max of these three patients was (15.7±5.1) cmH2O,which was statistically significantly lower than that of the other three groups [(102.7±39.3),(95.9±42.8),(77.0±27.4) cmH2O] (P＜0.05).Nine cases in the poor functional improvement group whose average Pdet.was (32.5± 16.6) cmH2O,which was statistically significantly lower than that of the other three groups [(115.2±36.3),(87.5±28.7),(75.5±46.9) cmH2O] (P＜0.05).Conclusions Urodynamic analysis plays an important role in judging the efficacy of TURP.Patients with a Pdet.max less than 32.5 cmH2O may not have an objectively successful result from surgery treatment.

Objective To investigate the effects of over-expression of wild-type PTEN gene and its mutant (G129E) on apoptosis and proliferation of activated hepatic stellate cells (HSC) in vitro and its potential mechanisms. Methods The activated HSC cells were cultured in vitro and transfected with PTEN gene and G129E gene via adenoviral vector. The apoptosis of HSC was measured by MTT , and its proliferation was assessed by TUNEL and flow cytometry (FCM) . Western blotting and real-time fluorescent quantitation PCR were used to detect expression of PTEN in HSC. And the changes of Bcl-2 and Bax expression were tested by Western blotting. Results The wild type PTEN gene and G129E gene were successfully transducted into HSC, which resuted in elevated expression of Bax and reduced expression of Bcl-2 (P<0.01). After transduction, HSC proliferation was markedly inhibited with inhibitory rates of 14.03% and 23.12% at 48 and 72 hours in Ad-PTEN ,respectively, as well as 9.52% and 12.63% in Ad-G129E, respectively. Apoptotic rate of HSC exposed to Ad-PTEN or Ad-G129E for 72 hours increased significantly (P<0.01). Furthermore, wild type PTEN was more powerful than G129E for above-mentioned effects. Conclusions Over-expression of wild type PTEN and its mutant G129E can inhibit the proliferation of activated HSC, and induce HSC apoptosis through the Bcl-2/Bax pathway. In addition, the effect of wild type PTEN is more powerful than that of G129E.

Objective To construct fusion gene and prokaryofie expression plasmid encoding the Rv1884c and Rv0867c genes in Mycobacterium tuberculosis (M.tb).The fusion protein wsg expressed efficienfly in E.coli cells.Methods The Rv1884c and Rv0867c genes were amplified by polymerase chain reactions (PCR) with specific primers from genomic DNA of M.tb H37Rv strain,and cloned into pGEX-4Tland pUC19 vectors.Rv1884c and Rv0867c were subcloned into the expression vector pGEX-4T-1 and pPRO-EXHT followed by DNA sequencing.The plasmids were transformed into E.coli DH5α and induced to produce GST-fused Rv1884c and His-fused Rv0867c fusion protein.The protein molecular weight and expression format was analyzed by SDS-PAGE.Results The recombinant expressive vectors pGEX-4T-1Rv1884c and pPRO-EXHT-Rv0867c were constructed.The DH5α strains of E.coli with recombinant plasmid showed high level of Rv1884c and Rv0867c gene expressions after IPTG induction.The SDS-PAGE showed that the plasmids expressed Rv1884c and Rv0867c fusion proteins with molecule weight of 45 000 and 80 000.The recombinant protein accounted for 18.3%and 23.7%of total bacteria protein.The expressed proteins could be purified via GSTrao FF and Ni2+-NTA system kits in denatured condition.Conclusions Mycobacterium tuberculosis Rv1884e and Rv0867c genes have been cloned and expressed Successfully in E.coli DH5α.The results lay a basis for further study of fast culfivation in Mycobacterium tuberculosis and investigation of their activities and functions.

Objective To evaluate the reliability and validity of the Chinese version of the King's Health Questionnaire (KHQ) in patients with overactive bladder(OAB).Methods The original English KHQ was translated into Chinese and linguistically validated following the Cross-cultural adaptation of health-related quality of life measures. Patients recruited randomly from urology clinics were scheduled for two visits with 2 weeks apart, and they were surveyed through the Chinese version of the KHQ. Internal consistency reliability was assessed by Cronbach's α test;Test-retest reliability was examined among stable patients using Intraclass correlation coefficient (ICC) and Spearman's rank correlation statistical analyses. Content validity was estimated by Spearman's rank correlation statistical analyses. A factor analysis was conducted to validate the underlying factor structure of the Chinese version of the KHQ. Results A total of 48 OAB patients who met the criteria participated the study, and 40 patients (7 men, 33 women) completed the questionnaires twice. All the subscales and domains of the KHQ showed high levels of internal consistency (Cronbach's a: 0.718-0. 924) , moderate to excellent test-retest reliability (ICC:0.551-0.923,P<0.01) and acceptable construct validity. The content validity was moderate to excellent except for the Social Limitations domain. Conclusion Psychometric testing supports the reliability and validity of the Chinese version of the KHQ as an OAB-specific measure of HR QOL.

Objective To evaluate the prevalence, associated risk factors and the impact on health related quality of life of overactive bladder (OAB) syndrome in Beijing adult women. Methods In the Community-based, cross-sectional study, 2973 women aged over 18 years who lived in urban and suburban communities respectively in Beijing were interviewed through Voiding Function Questionnaire, using a stratified system sampling approach. The women meeting the diagnostic criteria of OAB using the International Continence Society (ICS) definition were further interviewed through King's health questionnaire(KHQ) to estimate the impact of OAB on health related quality of life in Beijing adult women. Results A total of 2379(80.0%) women with complete data were included in this study. The overall prevalence of OAB was 4.7% (112/2379)and demonstrated an significant increasing with advancing age (P＜0.01). The prevalence of OAB was 2.0% in urban and 8. 1 % in suburban. In multiple logistic models, age, BMI, region of residence and anxiety level were associated risk factors for OAB. The result of King's health questionnaire showed the symptoms of OAB affect general health perception and sleep and energy severely. Conclusions The prevalence of OAB in Bei-jing adult women is 4.7%, lower than that of most reports in Occidental women, increases with advancing age, higher BMI and higher anxiety level, and is higher in suburban than in urban. The symptoms of OAB have a detrimental effect on quality of life.