Objective To observe the effect of transperineal injection of botulin A toxin on patients with detrusor-external sphincter dyssynergia caused by spinal cord injury. Methods Transperineal injection of botulin A toxin were performed in 6 patients with spinal cord injury (3 with cervical spinal cord injury and 3 with thoraco-lumbar spinal cord injury) complicated by detrusor-external sphincter dyssynergia.55 U of botulin A toxin was injected twice separately. The interval between 2 injections was 3 days.Before treatment, the residual volume of urine after voiding was determined and the maximum urethral pressure was measured by urodynamic testing.One month after treatment the examination mentioned above was repeated. Results The decrease in residual volume of urine was (133.3?70.9)ml.The decrease in maximum urethral pressure was (35.4?25.8)cmH 2O(both P

Objective:In order to evaluate the relationship between the activity of ALT and AST and the degree of spinal cord injury,we analyzed the activity of ALT and AST in serum of the patients with acute spinal cord injury(ASCI),the patients with fracture of spine and the ASCI patients at the recovery stage Methods:We investigated the ALT and AST activity in serum of 136 SCI patients in acute and recovery stages respectively by auto Olympus 600 biochemistry analysis instrument Results:The activity of ALT and AST of ASCI patients is much higher than that at recovery phase,and it is also higher than that of patients with spinal column fracture,while activity of patients with complete spinal cord injury is higher than that of patients suffered from incomplete spinal cord injury Conclusion:The activity of AST and ALT in serum may be related to spinal cord injury and its degree

This study is to compare the influence of CYP2D6 *3 and *4 genotypes and phenotypes on the metabolic activity of CYP2D6 in Chinese Han, Uygur and Kazakh ethnic groups. Allele specific amplification (ASA) was used to determine the CYP2D6*3 and CYP2D6*4 genotypes. Phenotypes of CYP2D6 in all subjects were determined using dextromethorphan as probe drug by HPLC methods. Among the 132 Han subjects, one subject (0.76%) exhibited the *1/*3 combination, and one (0.76%) exhibited the *1/*4. Among the 136 Uygur subjects, 4 subjects (2.94%) showed the *1/*3 combination, 12 (8.82%) showed *1/*4, 4 (2.94%) showed *4/*4, and one (0.74%) showed *3/*4. Among the 116 Kazakh subjects, 2 (1.72%) exhibited the *1/*3 combination, 7 (6.03%) exhibited *1/1*4, and one (0.86%) showed *4/*4. This research revealed significant differences in the occurrence frequencies of the CYP2D6 genotype between Han and Uygur ethnic groups, as well as between Uygur and Kazakh populations. However, no difference was found between Han and Kazakh populations. In addition, the prevalence of PMs of the Uygur is comparable to that of the Caucasians. However, the molecular mechanism underlying the poor metabolism is different in these two populations.

BACKGROUNDSurgical resection becomes standard treatment for pulmonary metastatic tumor with operative indication. The aim of this study is to analyze the indication and surgical efficacy of pulmonary metastasectomy.

METHODSFrom November 1991 to May 2003, a total of 26 patients with pulmonary metastatic tumors were treated surgically in our hospital, 12 cases were males and 14 females, with an average age of 50 years old. The metastatic tumors came from different organs and tissues, 5 cases accompanied by metastatic tumors of liver or brain.

RESULTSFour cases underwent pneumonectomy, 8 lobectomy, and 14 wedge resection (in which 8 cases underwent mildly invasive operation using video-assisted thoracic surgery). No operative death occurred. 5-year survival rate was 27.3% (3/11), 2-year survival rate 42.9% (9/21) and 1-year survival rate 69.2% (18/26).

CONCLUSIONSPulmonary metastasectomy is recommended in pulmonary metastases with operative indication, and is still effective in cases accompanied by resectable metastatic tumors of liver or brain. Mildly invasive operation using video-assisted thoracic surgery might be chosen for some cases with single metastatic locus.

OBJECTIVESTo improve the diagnosis of patients with neurogenic lower urinary tract dysfunction and to provide a basis for proper selection of rehabilitation methods.

METHODSThe urodynamics was tested with Assend Urodynamic Instrument in 220 patients with spinal cord injury. Of these patients, 100 received regular cystometrograrhy (CMG) and urethal pressure profile (UPP) test, and the remaining patients were measured by bladder/ external sphincter pressure profile. The detrusor pressure, maximum detrusor voiding pressure, and maximum urethral pressure were recorded. The date from the tests were processed with SPSS 8.0 (independent samples T test).

RESULTSThe maximum urethal pressure (83 +/- 39) cm H(2)O (1 cm H(2)O = 0.098 kPa) and maximum voiding detrusor pressure (12 +/- 10) cm H(2)O were lower in coda-equina group than in other groups (t = 2.096,P < 0.05). The group with different spinal cord injury had almost an equal ratio of low bladder compliance (51.2%, 52.4% and 50% separately). Statistical differences were found between complete injury and incomplete injury in each group(t = 1.023, P > 0.05). In bladder/external sphincter cystometry, urethral pressure profile could be classified into four types.

CONCLUSIONSThe maximum urethral pressure and maximum pressure of detrusor contractile were lower in the cauda-equina injury group than in other groups. The cauda-equina injury group showed a lower incidence of detrusor sphincter because most of these patients were incompletely injured. The features of urethral pressure profile in bladder/external sphincter cystometry resulted from the abnormal contraction of external sphincter and periurethral striated muscles.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Spinal Cord Injuries ; complications ; physiopathology ; Urinary Bladder ; physiopathology ; Urodynamics ; Urologic Diseases ; physiopathology

Objective To investigate the clinical significance and changes of serum interleukin-4 (IL-4),interferon-γ(IFN-γ) and immunoglobulin E (IgE) levels in infants with spasmodic laryngitis.Methods Serum samples were obtained from 50 children with spasmodic laryngitis and 30 healthy children.The changes of IL-4,IFN-γand IgE levels in serum when hospital admission (acute stage),before discharge (the stage of clinical symptom disappeared) and after 2 months of follow-up were observed.Enzyme-linked immunosorbent assay was used to determine the levels of IL-4 and IFN-γ in serum.Serum IgE level was determined with enzyme-linked fluoroimmuneassay.Results The serum level of IL-4 in patients with spasmodic laryngitis during acute stage were much higher than that in normal control group[(20.65 ±5.87) ng/L vs(8.23 ±2.71) ng/L,t =5.536,P ＜0.05].It was decreased during the stage of clinical symptom disappeared and significantly lower than that during acute stage[(11.07 ± 2.93) ng/L vs (20.65 ± 5.87) ng/L,F =5.258,P ＜ 0.05].The serum level of IFN-γ in patients with spasmodic laryngitis during acute stage were much lower than that in normal control group[(61.38 ±6.36) ng/L vs (108.42 ± 13.56) ng/L,t =4.831,P ＜ 0.05],and it was increased during the stage of clinical symptom disappeared [(95.12 ± 11.63) ng/L] and significantly higher than that during acute stage(F =4.239,P ＜ 0.05).There was no difference between the patients at clinical symptom disappeared stage and normal control group (P ＞ 0.05).Two months after discharge,there was no difference in serum INF-γlevel between the patients [(75.68 ±6.29) ng/L] and that in control group (P ＞ 0.05).The serum level of IgE in patients with spasmodic laryngitis during acute stage were much higher than that in normal control group [(136.63 ± 17.86) ng/L vs (47.16 ± 6.83) ng/L,t =6.685,P ＜ 0.05].It was decreased during the stage of clinical symptom disappeared [(88.07 ± 11.83) μg/L] and significantly lower than that during acute stage(F =5.182,P ＜ 0.05),but higher than that of normal control group (P ＜ 0.05).Two months after discharge [(86.72 ± 7.25) μg/L] it was still higher than that in control group (P ＜ 0.05).Conclusions There is TH1/TH2 imbalance in infants with spasmodic laryngitis.Maybe spasmodic laryngitis is one of the clinical manifestations of atopic diseases.IL-4,IFN-γand IgE may play important roles in immunologic pathogenesis.

Objective The primary aim of this study was to examine the proportion and natural history of Helicobacter pylori (Hp) negative bleeding peptic ulcers. Methods The study was designed as a multiple-center, case-control study conducted in 14 endoscopy centers in China from April 2006 to March 2007. Each center was expected to recruit 30 peptic ulcer patients with bleeding ( PUB group) and 30 without (PU group). All screened patients with upper gastrointestinal bleeding received endoscopy within 24 hours of admission. Biopsy specimens were taken from the antrum to determine Hp infection by rapid urease test and pathology. Patients with negative Hp infection at first examination were asked to receive urease breathe test (UBT) one month later. Results A total of 617 patients were enrolled with 263 in PUB group and 354 in PU group. There is no significant difference in demographic characters between 2 groups ( P ＞0. 05). The rate of Hp infection in PUB group ( 161/263, 61.2% ) was significantly lower than that in PUgroup (311/354, 87. 9%, P ＜0. 001 ). The incidence of complex ulcer in Hp positive PUB patients was 7.5% ( 12/161 ), which is significantly higher than that in Hp negative PUB patients ( 1/102, 1.0% , P =0. 018). In PUB group, no significant differences were found between Hp positive and negative patients in regarding of age, sex, rates of haematemesis, duodenal ulcer and gastric ulcer, and size of ulcer ( P ＞0. 05 ). Among 102 Hp negative cases in PUB, no positive case was found in UBT one month later. Conclusion We have demonstrated a rise in the incidence of Hp negative bleeding ulcers in China. The idiopathic ulcer was not rare, and might have a higher tendency to cause bleed.

Objective:To study the clinical manifestations and treatment of neonatal testicular torsion (NTT) and to summarize the experience of diagnosis and treatment.Methods:The clinical data of the patients with NTT admitted to the Department of Pediatric Urology in Guangzhou Women and Children's Medical Center from January 2015 to January 2021 were analyzed retrospectively. The data included demographic information, testicular torsion duration, clinical presentation, ultrasonography findings, surgical procedures, pathological results, follow-ups, and prognosis.Results:A total of 17 cases were enrolled in this study, and the median age was 5.2 d, ranging from 1 d to 17 d; the weight ranging from 2 800 g to 4 000 g. 11 cases of left testicular torsion and 6 cases of right testicular torsion. The median time from onset to medical attention was 3.8 d, ranging from 10 h to 15 d. The first manifestations being reported were scrotal swelling, color change, or painless mass. Emergency ultrasound revealed that the blood flow signal in the testis was significantly reduced or disappeared, and heterogeneous mass echoes were detected in the scrotum. Surgical exploration was performed in all 17 cases and confirmed to be testicular torsion. There were 15 cases of extravaginal torsion and 2 cases of intravaginal torsion. There were 6 cases of clockwise torsion and 11 cases of anticlockwise torsion. The average degree of twisted testis was 450.8°, ranging from 270° to 720°. The rate of orchiectomy was 88.2% (15/17). All patients were followed up for a minimum of 1 year postoperatively. None of the patients experienced postoperative bleeding or infection at the scrotal incision site. There were no instances of recurrent testicular torsion, and the contralateral testicles showed no abnormalities. In 2 cases where the affected testicle was preserved, ultrasound reevaluation at 6 months postoperatively revealed atrophy of the affected testicle.Conclusions:NTT is rare in clinics and lacks specificity, with a high rate of testis loss. When the newborns exhibit scrotal swelling, color change, or other abnormalities, testicular torsion cannot be ruled out, and early surgical exploration is required.

Child ; Humans ; Case-Control Studies ; East Asian People ; Genetic Predisposition to Disease/genetics* ; Methyltransferases/genetics* ; Polymorphism, Genetic ; Wilms Tumor/pathology*