Objective To study the value of the preoperative detrusor contractility to the outcome assessment of prostatectomy for benign prostatic hyperplasia (BPH).Methods A total of 109 patients with BPH were analyzed.Their ages ranged from 62 to 83 years with a mean of 71 years.All patients underwent urodynamic study to confirm a diagnosis of BOO preoperatively.Further more, their BOO was not caused by nervous, endocrine or other diseases.Pateints were divided into two groups based on maximum detrusor contractility.Group Ⅰ (n =61, BPH with maximum detrusor contractility ≥ 40 cm H2O, 1cm H2O =0.098 kPa) underwent TURP or open surgery, respectively.Group Ⅱ (n =48, BPH with maximum detrusor contractility ≤ 20 cm H2O ) underwent TURP and suprapubic punctural cystostomy simultaneously,the bladder fistula was kept open continuously for at least two weeks postoperatively.The difference in outcome between the two grous was assessed by using urodynamic parameters including maximum detrusor contractility, Qmax and residual urine at one and three months postoperatively respectively.Student's t-test was used to compare the result for normally distributed data and Wilcoxon's signed-ranks test for skewed data in this study.Results There was significant difference in preoperative maximum contractility, Qmax between group Ⅰand groupⅡ (78.4 ±37.0 cm H2O) vs (19.2 ±5.4 cm H2O)(P＜0.01), (7.6±2.2 ml/s) vs (2.5 ± 1.1 ) ml/s (P ＜ 0.05) respectively.Although there was significant difference at one month postoperatively in Qmax (17.4 ±2.9)ml/s vs (12.5 ±2.0)ml/s (P＜0.05), no significant difference was found in Qmax between the two groups after three months ( 18.3 ±2.8 ml/s) vs ( 15.2 ± 1.8)ml/s (P ＞ 0.05).Conclusions The Qmax may improve and the impaired detrusor recovered gradually after the BOO was removed.Performing an operation on patients with BOO accompanied with detrusor underactivity may be useful to recover detrusor contractility.

OBJECTIVE To investigate the repressor SmeT and other sequences of efflux pump SmeDEF in the clinic isolates of Stenotrophomonas maltophilia to involve in antibiotic resistance. METHODS The mRNA level of smeD examined the resistance profile of the clinical strains to antimicrobials was by agar dilution and their reaction to pump inhibitor was investigated by RT-PCR,and the smeD-smeT fragment was amplified by PCR,and then sequenced.Adding poly(A) to 3′ end of RNA,applying 3′RACE,nested PCR,then sequence-analysis. RESULTS The amino acid sequences of the forepart of SmeT were conservative in all the 7 strains.In antibiotic-resistant strains with positive reaction to pump inhibitor,the intergenic sequences of smeD-smeT were different from those in sensitive ones.The variations in(-165 to-82)nt of smeT and several nucleic acids before the start codon of smeT,possibly involved in antimicrobial resistance.All isolates didn′t have Leu166Gln mutation within the SmeT protein of D457R,which was reported possibly associated with antibiotic resistance.The resistant strains with efflux positively inhibited had Asp218Glu substitution,different from the negatively-inhibited ones. CONCLUSIONS The expression level of SmeDEF is related with the antibiotic resistance of S.maltophilia.The possible resistance mechanism includes the variations in the intergenic smeD-smeT and/or smeT codon sequence.

Objective To investigate the effects of levofloxacin,ciprofloxacin,ceftazidime,pip-eracillin,cefoperazone/sulbactam,erythromycin,sulfamethoxazole and gentamycin on the bacterial biofilms of Stenotrophomonas mahophilia.Methotis Biofilm and conventional susceptibilities were determined for S.maltophilia isolates from 42 patients.The model of S.maltophilia biofflms in vitro was developed in the Mueller-Hinton broth--micmtiter inoculator or silica films.After antibiotic challenge plate 20 h,each plate was sonicated and the absorbance value at 620 nm(A620)was measured on a microtiter plate colorimeter be-fore and after incubation for 6 h.Then the biofilm inhibitory concentrations were calculated.Finally,based on the acquired data.the experiments of combinafion effects of erythromycin with the 3 antibiotic agents on the formed biofilms of 5 picked strains were designed and worked out.Results The sensitive rate of 42 S.maltaphilia to levofloxacin.sulfamethoxazole and piperacillin were 83.33%,66.67%and 54.76%,re-spectively.The bilfilm inhibitory concentrations were much higher than the corresponding minimal inhibitory concentrateion after formed biofflms.Conclusion Forty-two S.maltophilia are multi-resistant to antibiotic agent.And levofioxacin may have a better effect against biofilms compared with others.The inhibition effect of combination erythromycin with levofloxacin is more obvious among all the 3 antibiotic agents.