Objective To summarize the experiences on clinical application of flexible cystoscopy,and evaluate the significance of applying flexible cystoscopy in urologists' daily practice.Methods A total of 379 patients underwent examination with flexible cystoscopy,of them 74 patients were with the aim of therapy or related operation.The operation time was counted and the patients' discomfortableness was recorded according to a visual analog scale(VAS).What's more,a satisfaction questionnaire was made by no doctor presenting to check the patients' response to cystoscopy operation.36 male patients were undergone both rigid and flexible cystoscopy operation.The statistical significance of the differences was analyzed after reading the VAS scores and the results of questionnaires were evaluated.Results 223 patients were found to have relative diseases by the examination of flexible cystoscopy.The mean operation time in using flexible cystoscopy was 7.8?0.27 minutes.The median pain scores of male and female patients were 2.9 and 1.3,respectively.The maximum pain was felt by male patients when the cystoscopy went through the membran of urethra.Satisfactory rate in male patients was 99%,and it was 100% when evaluating the questionnaires answered by female patients.For the 36 male patients undergone both rigid and flexible cystoscopy operation,the median pain score was 2.1(0.5-4.5) for flexible cystoscopy,and was 5.7(1.0-10.0) for rigid cystoscopy.After flexible cystoscopy examination,all the 36 patients were satisfied by the operation.However,only 61.1%(22/36) patients were satisfied by the rigid cystoscopy operation.Statistical analysis showed significant difference(P

Objective To evaluate the effect of 5? reductase inhibitor on vascularity of benign prostatic hyperplasia (BPH). Methods Sixty male adult rats were randomly divided into 4 groups (15 per group): normal control, BPH control group, the group of 5? reductase inhibitor treatment during hyperplasia and the group of treatment after hyperplasia. Immunohistochemistry combined with computer assisted image analysis system were performed to examine the expression of factor Ⅷ related antigen, PCNA and VEGF in the prostatic tissue for all rats. Results The microvessel density(MVD) and the expressions of PCNA and VEGF were much less in treatment during hyperplasia and treatment after hyperplusia than that in BPH control group( P

Objective To explore the effect of different dosage of radial extracorporeal shock waves on fracture disunite and bone nonunions.Methods 42 patients were divided into 3 groups based on the different shock dosage, every group contained 14 patients and the shock dosages were 1000, 2000 and 3000 in Groups A, B and C respectively. All patients accepted the therapy for 3 times and followed up with X rays. Results 3 months after treatment, calluses were formated iin 2(14.7%), 8(57.1%) and 8(57.1%) patients in 3 groups respectively,which was lower in Group A than in Groups B and C (P<0.05), but there was no significant difference between Group B and Group C (P>0.05). 9 months after treatment, the corresponding cure rates were 28.6%, 85.7% and 78.6% in 3 groups respectively. The cure rate was lower in Group A than in Groups B and C (P<0.05), but there was no significant difference between Groups B and C (P>0.05). Conclusion The radial extracorporeal shock waves had dose-dependence and saturation for the shock dosage, 2000 is the optimal choice

Objective To establish a calculation method for the voiding work parameters by using the detrusor power curve and to evaluate its clinic efficacy.Methods From January 2001 to January 2011,132 male patients with benign prostate hyperplasia who underwent urodynamic tests were retrospectively reviewed.The patients' age ranged from 45 to 84 years old (mean 57 years old).All patients had no previous history of neurological disease and no positive findings in neurological examinations.The voiding work of bladder,the voiding power of bladder and voiding energy consumption were calculated by using the detrusor power curve method and the linearized passive urethral resistance relation analysis was conducted.According to the detrusor status,all patients were divided into the decreased detrusor pressure group,the normal detrusor pressure group and the increased detrusor pressure group.Meanwhile,normal urethral resistance group and the increased urethral resistance group were classified according to the urethral resistance status.The detrusor pressure at maximal flow rate (PdetQmax),the maximal flow rate (Qmax),the projected isovolumetric pressure (PIP),the voiding work,the voiding power and the voiding energy consumption were compared among the different groups.Results There were 56 cases,58 cases,18 cases in the decreased,normal and the increased detrusor pressure group respectively.The voiding work were (1.1 ± 0.5)J,(1.7± 0.7)J,(2.1±1.2)J; the voiding power were (15.3±7.3)mW,(31.9±12.6)mW,(42.5±21.1)mW; and the voiding energy consumption were (3.9± 1.2) J/L,(5.2± 1.9) J/L,(6.2±3.2) J/L in those three groups,respectively.With the increasing of detrusor pressure,PdetQ Q PIP,the voiding work,the voiding power and the voiding energy consumption all increased among three groups with significant difference (P＜ 0.05).There were 51 cases,81 cases in the normal and the increased urethral resistance group.The voiding work were (1.5±0.7)J and (1.5±0.8)J;the voiding power were (32.3±13.2)mW and (22.6±16.3)mW and the voiding energy consumption were (3.8±0.7) J/L and (5.4±2.4) J/L in two groups.The increased urethral resistance group had higher PdetQmax and voiding energy consumption (P＜0.05) and lower Qmax and voiding power (P＜0.05) than those in the normal urethral resistance group.However,the differences of PIP (P =0.438) and the voiding work (P =0.546) between the two groups were not determined.Conclusions The detrusor power curve method can be used to calculate the work parameters of voiding.This method can be applied to evaluate the compensatory state of bladder and is conductive to urodynamic analysis in low detrusor pressure status.Both detrusor pressure and urethral resistance had significant impact on the work capacity of bladder.

Objective To present our experience of dealing with complete penile amputation.Methods Two cases of penile complete amputation were reported.The first case was a 34-year-old man,suffered amputation of the penis approximately 2.5 cm distal from the pubic area with a sharp knife.3.5hours later,the patient was transferred to our hospital.The urethra mucosa and corpus spongiosum were anastomosed.The cavernous body of the penis was reattached by suturing the tunics albuginea of each corpus cavernosum to the corresponding proximal segment.One dorssl artery,two dorsal veins,and dorsal nerve were anastomosed under a 10 × microscope with interrupted 9-0 nylon nonabsorbable sutures.The second case was a 25-year-old man,presented to the emergency room 15 hours after distal penile amputation,which had 2 wounds as a result of self-mutilation caused by psychiatric problems.The urethra mucosa and corpus spongiosum were anastomosed.The cavernous body of the penis was reattached by suturing the tunics albuginea of each corpus cavemosum to the corresponding proximal segment using 4-0 polyglactic acid sutures.Results In the first case,the tourniquet was released after replantation,and the distal penis appeared to revascularize,as noted by the gradual increase in redness and size.An arterial pulse was detected,and the superficial penile veins displayed normal turgor,and no bleeding was found.On postoperative day 3,the penile skin started to necrotize.On day 12,the necrotic skin was superficially debrided,and a fistula was observed in the corresponding urethral segment.Two weeks later,the fistula was sutured with 4-0 interrupted synthetic absorbable suture,and a transposition flap to embed the whole injured penis shaft was created from the proximal scrotal skin.The glans was exposed.Two months after the second operation,the embedded penis was released from the scrotum.After follow-up of two years,the patient had glans re-epithelialization with normal voiding,sensation,and erections.In the second case,the glans was still pink,but the penile skin started to necrotize on postoperative day 3.On day 14,serious infections were noted,the necrotic skin was superficially debrided,and the amputated penis was relieved.Conclusions Prompt diagnosis and early treatment are essential to avoid the potential complications of ischemic necrosis and autoamputation.Venous outflow is a critical factor for success of replantation.Microsurgical reanastomosing of the dorsal penile vein,penile arteries,and dorsal nerves can be identified as the standard method for penile replantation.The bipedicled scrotal flap can provide adequate skin cover for penis defects.

Objective To study the effect of extracellular matrix(ECM)of xenogenic femoral fascia which is a tissue-engineering material in repair of renal trauma.Methods Twenty-four experiment dogs were divided into 3 groups:group 1(n=10),the kidneys were repaired using ECM of xenogenic femoral fascia;group 2(n=10),the kidneys were repaired using self-omentum;group 3(n=4),xenogenic femoral fascia was used as repair materials.The animals were sacrificed separately at 1,2 weeks and 1,2,4 months after renal repair operations in group 1,2.In group 3,the animals were sacrificed separately at 2 weeks and 2 months after renal repair operations.The examinations of blood routine were performed before and after operations immediately,blood creatinine and serum renin were measured before operations and before death.The creatinine clearances of affected and contralateral normal kidneys were evaluated before death and the local areas of renal repair were studied by light and scan electron microscopy.Results In group 1,bleeding stopped rapidly and completely after the entire patch was sutured,only mild adhesions to surrounding tissues were found in various times after operations.As time passed,the repair patch was replaced by smooth neocapsule just like a normal one.In group 2,the bleeding volume in the operations was larger than the other 2 groups.It was diffieult tO separate the kidneys from the surrounding tissues.The wounds gradually contracted because of the scar forming.In group 3,there were severe immunological reactions in the patchs.Conclusion ECM of xenogenic femoral fascia is an ideal tissue-enginee rjng material for renal repair.

Objective: To study the effect of extracellula matrix of xenogenic femoral fascia in repair of renal trauma. Methods: Twelve adult dogs were used and randomly assigned to 6 groups, and the animals were sacrificed separately in 1 and 2 weeks 1,2,4 and 8 months after renal repair operations. The examinations of blood and urine routine, blood urea nitrogen and creatinine, electrolyte and serum renin were performed before and after operations at various times. The creatinine clearances of affected and contralateral normal kidneys were evaluated before death and the local areas of renal repair were studied by light and electron microscopy. Results: Bleeding was stopped completely after the entire patch was sutured, and only mild adhesions to around tissues were found in various times after operations. As time passed, the repair patch was replaced by smooth neocapsule like normal renal capsule. Conclusion: Extracellula matrix of xenogenic femoral fascia might be an ideal tissue-engineering material for renal repair.

Quality variation and ecotype classification of Chinese herbal medicine are important scientific problems in Daodi herbal medicine research. The diversity of natural environmental conditions has led to form unique multi-Daodi, multi-product areas that produce particular Chinese herbal medicine. China is one of three big American ginseng (Panax quinquefolium L.) producing areas worldwide, with over 300 years of application and 40 years of cultivation history. Long-term production practice has led to the formation of three big advocate produce areas in China: Northeast province, Beijing and Shandong. P. quinquefolium L. grown under certain environmental conditions will develop long-term adaptations that will lead to more stable strains (different ecotypes). P. quinquefolium L., can vary greatly in quality; however, the ecological mechanisms causing this variation are still unclear. Root samples were collected from four-year-old cultivated P. quinquefolium L. plants in the three major genuine (Daodi) American ginseng-producing areas of Northeast province, Beijing and Shandong province, China. Ultra-performance liquid chromatography was used to analyze the contents of eight ginsenosides (Rg1, Re, Rb1, Rb2, Rb3, Rc, Rd, Rg2). Data for nine ecological factors, including temperature, moisture and sunlight, were obtained from the ecological database of Geographic Information System for Traditional Chinese Medicine. Soil samples from the sampling sites were collected. Effective boron and iron, available nitrogen and potassium, as well as other trace elements and soil nutrients, were determined by conventional soil physicochemical property assay methods. Analytical methods of biostatistics and numerical taxonomy were used to divide ecotypes of the three main Panax quinquefolium L. producing areas in China based on ginsenoside content, climate, soil and other ecological factors. To our knowledge, this is the first time that ecological division of P. quinquefolium L. producing areas in China has ever been conducted. The results show that there are two chemoecotypes of P. quinquefolium L. in China: ginsenoside Rb1-Re from outside Shanhaiguan, and ginsenoside Rg2-Rd from inside Shanhaiguan. Similarly, there are two types of climatic characteristics: inside Shanhaiguan (Beijing, Shandong) and outside Shanhaiguan (Northeast). This suggests that the formation and differentiation of chemoecotypes of P. quinquefolium L. is closely related to variability of the climatic and geographical environment. Additionally, ecological variation of the three main producing areas, characteristics of two climatic ecotypes, and soil characteristics are also discussed and summarized. These results provide experimental scientific evidence of the quality variation and ecological adaptation of P. quinquefolium L. from different producing areas. They also deepen our understanding of the biological nature of Daodi P. quinquefolium L. formation, and offer novel research models for other multi-origin, multi-Daodi Chinese herbal medicines ecotypes. In addition, the results demonstrate the critical need for improving quality, appropriate ecological regionalization and promoting industrialized development of P. quinquefolium L.

Objective To investigate cortactin expression in malignant colorectal tissues and corresponding adjacent non-cancerous colon tissues,precancerous lesions (adenomatous polyps) and the relationship between the expression of cortactin and cell division in colorectal cancer cells.Methods The expression of cortactin was detected by immunohistochemistry in colorectal cancer,colorectal adenomatous polyp (precancerous lesions) and colorectal tissues adjacent to adenocarcinomas (normal tissues).Kaplan-Meier method was employed to compare the survival between the groups.Cortactin expression and cell division were detected by Western blot and immunofluorescence in SW-620 colon cancer cells treated with cortactin siRNA.Results The positive expression rate of cortactin was significantly higher in colorectal cancer tissues than in adenomatous polyp tissues and pericarcinomatous normal tissues.Overexpression of cortactin in colorectal cancer tissues was correlated with poor differentiation (P ＜ 0.01),lymph node metastasis (P =0.006),and TNM stage (P =0.022).The 5 year survival rate of the group of negative/weak positive expression of eortactin was significantly higher than the group of strong positive expression of cortactin.CTTN gene amplification in colorectal cancer tissues was obvious.Cortactin siRNA induction caused a lower cortactin protein expression in colorectal cancer cells.Conclusions It is suggested that the excessive expression of cortactin contributes to the growth of cancer cells in colorectal cancer.

Objective To quantitatively analyze the fund theses published in the Journal of Practical Radiology(JPR)and Chinese Journal of Radiology(CJR)in order to detect effective approaches to the improvement of the journal quality and academic level of the JPR.Methods The number of funds-supported theses published,the ratio of fund theses,grade,regional,source of institutions and publication time-lag distribution of the fund theses were statistically analyzed by using bibliometrics in the two journals in 2013.Re-sults Six hundred and eighteen theses were published in JPR in 2013,the total number of fund theses were 137(accounted for 22.2% of total articles),the ratio of fund theses were 0.22,the provincial and municipal fund theses accounted for 59.2%.All fund theses were from 23 regions and 82 institutions throughout the country.The average of publication time-lag was 235.6 days.Three hundred and thirteen theses were published in CJR in 2013,the total number of fund theses were 97(accounted for 31.0% of total articles),the ratio of fund theses were 0.31,the provincial and municipal fund theses accounted for 32.0%.All fund theses were from 18 regions and 70 institutions throughout the country.The average of publication time-lag was 228.4 days.Conclusion JPR has its own superi-ority,meanwhile,it also has a significant disparity and insufficiency comparing to CJR.In order to further promote the quality conno-tations and the academic level of JPR,efforts should be made on subject selection and planning,initiative collection of manuscripts, priority publishment to excellent manuscripts,shortening publication time-lag,etc.Additionally,a database of core authors and ex-perts should be established.