Objective To observe the curative effect of Jiawei-Haiqi pill on senile osteoporosis. Methods 124 patients in Shantou hospital of Traditional Chinese orthopedics were gathered from May 2010 to December 2012 in accordance with the criterion of diagnosis of senile osteoporosis. The 124 patients were divided into 2 groups randomly according to their case number. Sixty cases in the study group were treated with Jiawei-Haiqi pill, 6 gram per time once a day. Sixty-four cases in the control group were given 50 IU salmon calcitionin see calcimar via intramuscular injection once a day in the fist week, once every two days in the second week, and once every three days in the third week. Both groups were treated for 3 weeks with 3 months visit. After the end of treatment, symptom score, record the bone mineral density and biochemical markers of bone metabolism(serum alkaline phosphatase(ALP), Fasting bone gla protein(BGP), Urinary calcium(UCa) were observed in both groups. Results ①Comparison of curative effect of osteoporosis: After 3 weeks treatment, the total effective rate was 85.0%(51/60) in the study group and 79.7%(51/64) in the control group. There was no significant difference(P=0.776) between the two groups. ②Comparison of bone mineral density effect:the total effective rate was 40%in the study group and 39.1%in the control group.The difference between the two groups was not statistically significant(P=0.991). ③Bone mineral density and symptom score changes bone mineral density in the two groups after 3 weeks and 3 months treatment [The study group respectively(0.69±0.08)g/cm2, (0.70±0.10)g/cm2, the control group respectively(0.69±0.0)g/cm2, (0.70± 0.13)g/cm2] increased than those in the same group before treatment[The study group (0.69±0.05)g/cm2, the control group (0.69±0.10)g/cm2], but there were no significant difference within group and between group comparisons(P>0.05);symptom score in the two groups after 3 weeks and 3 months treatment [The study group respectively(9.90±2.00)min,(8.50±1.70)min, the control group respectively (10.40±2.40)min, (9.00±1.90)min] reduced than those in the same group before treatment[The study group(16.10±2.00)min, the control group (16.20±1.80)min] (P<0.05), but there were no significant difference within group and between group comparisons(P>0.05). ④Biochemical markers of bone metabolism changes, after 3 weeks treatment, BGP in the study group(9.08±5.05)ρ/(?g?L)increased than that before treatment (5.10±3.50)ρ/(?g?L)(P<0.05). Conclusion Jiawei-Haiqi pill could effectively improve the clinical symptoms of aged patients with osteoporosis and elevate the levels of their BGP.

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.

AIM:To study the role of prostaglandin F2?(PGF2?) in cardiac hypertrophy and its relation with calcineurin(CaN) signal transduction pathway in vitro.METHODS:The cultured neonatal rat cardiomyocyte was used to observe the hypertrophic effect of PGF2?,and the hypertrophic response was assayed by measuring the cell diameter,protein content and atrial natriuretic factor(ANF) mRNA expression.For mechanism studies,the intracellular free calcium concentration([Ca2+]i) in cultured cardiomyocytes was measured by using Fura-2/AM as a fluorescent indicator.ANF and CaN mRNA expressions,and the expressions of CaN and its downstream effectors,NFAT3 and GATA4 proteins were assayed by RT-PCR and Western blotting,respectively.RESULTS:In cultured cardiomyocytes,PGF2? induced profound hypertrophic morphology change and the significant increase in cell diameter,and protein content in a concentration-dependent manner compared with those in vehicle control(P

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.

Objective:To evaluate the efficacy of low-intensity extracorporeal shock wave therapy (LI-ESWT) in patients with traumatic erectile dysfunction.Methods:The present study included 62 patients with traumatic erectile dysfunction, including 30 patients treated with low intensity shock waves and 32 controlled patients. The treatment groups were performed six times (twice per week), each by 3 000 impulses. The follow-up was performed 4, 8 and 12 weeks after LI-ESWT. The International Index of Erectile Function-5 (IIEF-5), nocturnal penile tumescence (NPT) and the Erection Hardness Score (EHS) were used to evaluate the therapeutic efficacy of LI-ESWT.Results:LI-ESWT could significantly improve IIEF-5 (15.67±3.89 vs. 9.41±4.66, P<0.01). 67% of patients in the LI-ESWT group and none of the control group answering 'yes’ to the SEP-Q2 elevated. In the low intensity shock wave treatment group and the control group 67% and 0 of patients, respectively, achieved erection hard enough for vaginal penetration, that is an EHS (Erection Hardness Score) of 3 ( P<0.01). According to changes in the IIEF-5 score treatment was effective in 70% of men who received low intensity shock wave treatment but in none in the control group ( P<0.01). Therapeutic efficacy could last 12 weeks ( P<0.05). No adverse events were reported during and following treatment. Conclusions:These studies suggest that LI-ESWT could improve the IIEF and EHS of traumatic ED patients.

Objective To evaluate the cause of evaluated postage-specific antigen(PSA)in patients performed transrectal uhrasonography(TRUSG)guided prostate biopsy beeause of high PSA levels.Methods In a retrospective study 504 prostate biopsies performed between January 1998 and December 2001 were evaluated and the levels of serum PSA were determined in samples obtained immediately before sextant biopsy was performed.All patients underwent 6 or 13 cote primary prostate needle biopsies.Results 185 prostate cancer,109 NIH-Ⅳ prostatitis and 210 patients with benign prostate hyperplasia(BPH)were identified.The difference in free-PSA,total-PSA,f/t-PSA levels between prostate cancer,BPH and NIH-Ⅳ prostatitis was significant(P＜0.05).No significant difference was found in age,transrectal ultrasonography and digital rectal examination.In multivariate analysis,free-PSA,total-PSA,f/t-PSA was the significant predictors of histology in prostate cancer(P＜0.05).A significant correlation was found between the serum total and free PSA levels and the grade and stage of prostate cancer(P＜0.05).Preoperative variables predictors of histology in BPH were TPSA and FPSA(P＜0.05).In multivariate analysis,TPSA was the only significant predictors of histology in BPH(P＜0.01).The best cutoff value was constructed to differ pathology type in prostate diseases:tPSA≥4 ng/ml,fPSA≥0.85 ng/ml and f/t-PSA≤0.16(P＜0.05).Conclusions High serum PSA levels may correlate with asymptomatic inflammatory prostatitis,prostate cancer and BPH.The factors contributing to elevated serum PSA concentrations include cell proliferating,glandular epithelial disrupt.

Objective To discuss the relationship between asymptomatic prostatic inflammation (NIH category Ⅳ prostatitis)and serum prostate specific antigen. Methods In a retrospective study,245 prostate biopsies with benign pathological results from January 1998 to January 2000 were reviewed and the corresponding serum PSA before biopsy were analyzed.All patients were taken 6 or 13 cores prostate biopsy. Results One hundred and twenty-seven NIH-Ⅳ prostatitis and 118 patients with benign prostatic hyperplasia(BPH)were identified.The difference in free-PSA,totalPSA,f/t-PSA levels between BPH and NIH-Ⅳ prostatitis was significant(P＜0.05).In multivariate analysis,free-PSA,total-PSA,f/t-PSA was the significant predictors of histology in NIH-Ⅳ prostatitis(P＜0.05).The best prediction factors were constructed to predict pathology type in NIH-Ⅳ prostatitis:TPSA≥4 ng/ml,fPSA≥0.85 ng/ml and f/t-PSA≤0.16(P＜0.05). Conclusions Asymptomatic inflammation of the prostate was one of the confounding factors in patients with an elevated PSA.In the diagnosis of prostate diseases,it should be taken into account prostatitis might elevate the level of PSA.

Objective To analyze the clinical outcome of definitive perineal urethrostomy for the treatment of complex adult anterior urethral strictures.Methods From June 2012 to February 2018,28 patients who underwent the definitive perineal urethrostomy for a complex anterior urethral stricture were retrospectively reviewed.The mean age of the patients was 62.3 (range 34 to 77) years and stricture etiology was lichen sclerosus in 46.4％ (13/28) of the cases,iatrogenic stricture after transurethral resection of the prostate in 35.7％ (10/28),failed hypospadias repair in 10.7％ (3/28),infection 3.6％ (1/28)and idiopathic etiology 3.6％ (1/28).The mean stricture length was 9.6 (range 4.5 to 16.0) cm and the stricture length ＜5 cm in 7.1％ (2/28) of the cases,5-10 cm in 35.7％ (10/28) and ＞ 10 cm in 57.1％ (16/28).0f28 patients 21 (75％) underwent prior urethral dilation,4 (14.3％) underwent direct vision internal urethrotomy (DVIU) and 17 (60.7％) underwent urethroplasty.Among the medical history of interest,hypertension was observed in 17 patients (60.7％),chronic ischemic heart disease in 11 patients (39.3％),diabetes mellitus in 9 patients (32.1％) and chronic obstructive pulmonary disease (COPD) in 9 patients (32.1％).All patients completed the perineal urethrostomy with inverted U-shaped perineal skin flap.The patient was placed in a normal lithotomy position and an inverted U-shaped perineal incision was made.We can get an inverted U-shaped perineal skin flap after dissecting along the bulbospongiosus muscle.The bulbar urethra was opened along the ventral surface and the margins of the spongiosum tissue were closed with perineal skin flap.We analyzed the clinical characteristics of the patients,the outcome of the technique and investigated the satisfaction rates of the patients by outpatient follow-up or telephone interview.Surgical success was defined as functional voiding without the need for further procedures.Results The perioperative complications included 3 cases of urinary tract infection,1 case of bleeding and 1 case of wound dehiscence.Mean follow-up length was 27.2 (range 6.0 to 64.0)months.Of 28 cases 26 (92.9％) were successful and the mean maximum urinary flow rate was 26.5 (range 17.0 to 40.0) ml/s.Postoperatively,2 cases of urethrostomy strictures were found in 2 months and 4 months,respectively.They required periodic outpatient dilation and the younger one was in the waiting list for revision of the perineostomy and the older one refused the revision.Of 28 patients 24 (85.7％) were satisfied with the results obtained with surgery,15 were very satisfied,9 cases satisfied and 4 cases dissatisfied.Conclusions The successful rate of the definitive perineal urethrostomy for the complex adult anterior urethral strictures was high and patients were satisfied with the outcome of the surgery.The definitive perineal urthrostomy is a well-tolerated treatment option for patients with complex anterior urethral strictures,especially for those aged and with extensive comorbidities.

【Objective】 To explore the impacts of groove negative pressure drainage on the short-term prognosis of patients with transperineal anastomotic urethroplasty. 【Methods】 A retrospective case-control study was conducted to analyze the clinical data of 78 patients who underwent transperineal anastomotic urethroplasty during May 2021 and Apr.2022, including 42 patients in the groove negative pressure drainage group (experimental group) and 38 in the rubber strip drainage group (control group). The postoperative drainage volume, rate of scrotal edema, rate of infection, visual analog scale (VAS) score, and maximum urine flow rate were compared between the two groups. 【Results】 Compared with the control group, the experimental group had a longer length of incision [ (12.9±1.6)cm vs. (12.1±1.5)cm, P=0.041] and larger drainage volume 3 days after surgery [(66.1±51.9)mL vs. (36.0±16.9)mL, P=0.001] , but lower rate of scrotal edema (21.4% vs.47.2%, P=0.016) and lower VAS score (3.2±1.0 vs.3.9±1.1, P=0.008). There were no significant differences in the infection rate 7 days after surgery and the maximum urine flow rate 1 month after surgery (P>0.05). 【Conclusion】 Groove negative pressure drainage can be used to drain the effusion of perineum tissue adequately and decrease wound-specific complications, which is beneficial to the rapid recovery after transperineal anastomotic urethroplasty.