Objective To investigate the effect of matrix metalloproteinase-9 (MMP-9) on the prognosis of transient ischemic attack(TIA). Methods Sixty-four patients with first-onset TIA(TIA group)and 64 age and sex matched cases without any cerebrovascular disease (control group) were involved in this study. The level of MMP-9 was measured by ELISA method,and the subsequent vascular events and death rate were determined in both groups over 4 years. Results The level of MMP-9 in TIA group was significantly higher than that in control group [(5.25 ± 0.51 ) μg/L vs. (3.25 ± 0.39 ) μg/L, t = 7.830, P <0.05]. Furthermore, in TIA group, the level of MMP-9 was significantly higher in patients with primary endpoint events than that in the patients without primary endpoint events [(5.78 ± 0.48) μg/L vs. (3.15 ±0.29) μg/L, t = 3.250, P < 0.05]. Compared with the patients with lower MMP-9 level ( < 2.5 μg/L), the relative risk of primary endpoint events in higher MMP-9 level patients ( > 4.5 μg/L) was 2.612 (95% CI 1.557-5.463 ,P < 0.01 ) in TIA group. This increased relative risk for primary endpoint events in TIA group persisted after the adjustment for age, sex, body mass index, blood fat level and other cardiovascular risk factors such as hypertension, diabetes and smoking (OR =2.346,95% CI 1.418-5.216,P =0.006).Conclusions The level of MMP-9 in TIA patients has relationship with prognosis and inflammation may play an important role in TIA. MMP-9 may be a marker in predicting prognosis.

Objective To evaluate the effectiveness of the treatment of slight and moderate benign prostatic hyperplasia(BPH)with large doses of cemilton by urodynamie test.Methods A systematic review of using large doses of cernihon only for 80 patients with BPH with 7 grade ＜ International Prostate Symptom Score(IPSS)≤20 grade.All cases with cemilton had been administered in a dosage of 750 mg,three times a day for one year.All were respectively given IPSS,postvoiding residual urine(PVR),maximum flow rate(Qmax)and pressure-flow(A-G)test in order to assess the effectiveness at pre-treatment and 3,6,12 months after treatment.Results All patients had followed up for(1.2±1.6)years,additionally 26 of those were removed and others had received complete follow-up.Before the treatment IPSS was(20.5±4.5)grade,PVR was(42.5±8.2)ml,Qmax was(10.2±2.3)ml/s,A-G was 56.5±12.8,PQmax was (54.8±13.7)mm Hg(1 mm Hg = 0.133 kPa),and 12 months later,IPSS was(11.0±3.3)grade,PVR was (15.9±7.4)ml,Qmax was(15.7±2.5)ml/s,A-G was 49.2±13.6,PQmax was(43.6±14.9)mm Hg.There were significantly difference between pre-treatment and post-treatment data of the urodynamics(P ＜ 0.05).Conclusions The effectiveness of the treatment of slight and moderate benign prostatic hyperplasia with large doses of cemihon are relatively satisfactory.Main post-treatment urodynamic parameters obviously improves than that of the pre-treatment.

Objective To analyze videourodynamic characteristics of female bladder outlet obstruction (BOO). Methods Retrospective analysis of videourodynamic characteristics were performed in 42 women with BOO. On the basis of the videourodynamic findings, women with BOO were categorized into five groups: bladder neck obstruction, middle urethra (urethral sphincter) obstruction, distal urethra obstruction, external orifice of urethra obstruction, high-grade pelvic organ prolapse. Data of five groups were compared in Qmax, maximum cystometric capacity, Pdet at Qmax, residual urine, detrusor instability and hydronephrosis. Data of all patients were analyzed by SPSS13 statistical software, measurement data by t-test and enumeration data by x2-test. Results Five groups had not significant deviation in the maximum cystometric capacity. however patients with bladder neck obstruction had significant deviation with others in Pdet at Qmax (78. 0 ± 23. 6)cm H2O, residual urine (120. 6±115.2)ml, Qmax (7.0±2.3)ml/s (P<0.05). There was significant deviation between middle urethra (urethral sphincter) obstruction(76.9%)and others in detrusor instability(P<0. 05). In all patients with hydronephrosis, bladder neck obstruction(57. 1 %) had significant deviation with others (P<0. 05). Conclusions Videourodynamic tests could assess lower urinary tract function, and may guide clinic management. The bladder neck obstruction was most serious and harmful to upper urinary tract.

Objective To evaluate the effectiveness of the treatment of high risk benign prostatic hyperplasia (BPH) with transrectal high-intensity focused ultrasound (TR-HIFU) by urodynamic test. Methods One hundred and thirty patients with BPH, most of who suffering with diabetes mellitus,cardio-cerebrovascular disease, respiratory disease. All patients were given the operation with Sonablate-500 high-intensity focused ultrasound (HIFU). International prostate symptom score (IPSS), quality of life (QOL), maximum urinary flow rate (Qmax), post void residual urine volume (PVR), pressure-flow tests (A-G) were employed for the evaluation of curatives effect on preoperation, 30th and 90th day after the treatment. Results The duration of the TR-HIFU prostate ablation treatment was 15-85 rain. One hundred and seven patients after treatment were followed up for 3 months. Compared the effect before treatment with that after treatment, IPSS improved from (27.0 ±11.5) scores to (8.5±1.4) scores, Qmax increased from (5.7±2.3) ml/s to (14.1±4.2) ml/s, PVR decreased from (118.5±78.0) ml to (30.0±15.0) mI,A-G parameters reduced from 62.4±19.3 to 25.6±13.0 and urine volume (VV) increased from (85.8 + 42.0) ml to (194.0±52.0) ml. The parameters all altered obviously (P < 0.05). Conclusions TR-HIFU appears highly attractive as a new optional, safe and efficacious and minimally invasive treatment for the high risk BPH. Main post-operative urodynamie parameters are more obviously improved than those of the preoperation.

Objective To investigate the use and effect of dorsal dartos flap wrapping technique in complicated hypospadias fistulas repairs. Methods In the experimental group, the closed fistulas were wrapped with transferred dorsal dartos flap in the 32 cases of complicated hypospadias fistulas from March 2004 to January 2008. In the control group, the routine fistulas repairs were preformed in the 50 cases of complicated hypospadias fistulas from January 1998 to February 2004 . Results All cases had been followed up for 3 - 12 months, there were no fistula in the experimental group. There were 6 fistulas in the control group. There was significant difference between two groups (P<0.05). Conclusions The use of the technique can prevent urethrocutaneous fistulas after complicated hypospadias fistulas repairs, the fistulas rate are reduced for all cases combined. The technique would be the optimal repair for complicated hypospa-dias fistulas.

Objective To study the role of serum Hcy level change in predicting the effects of pemetrexed (PEM ) chemotherapy for treating the patients with advanced lung adenocarcinoma .Methods Fifty‐seven cases of lung adenocarcinoma treated by the PEM chemotherapy were retrospectively analyzed .The fasting venous blood was collected for detecting serum Hcy level before chemotherapy and at the end of 2‐week chemotherapy .The clinical characteristics ,Hcy level before and after chemotherapy and the relation between the Hcy level with clinical effect were statistically analyzed .Results In the therapeutic effects evaluated by the im‐aging examination during treatment process ,there were no case of complete remission (CR) ,19 cases of partial remission (PR) ,22 cases of stable diseases(SD) and 16 cases of progressed diseases(PD) ,the objective response rate(ORR) was 33 .3% and disease control rate (DCR) was 71 .9% .Different clinical factors had no significant influence on the efficacy of PEM chemotherapy (P>0 .05) .In comparing the influence of Hcy level and Hcy level change on the effect of PEM chemotherapy ,the results showed that serum Hcy level before treatment had no obvious influence on curative effect ,DCR in the patients with normal serum Hcy level after treatment was significant higher than that with abnormal Hcy level ,ORR and DCR in the patients with decreased Hcy level after chemotherapy were significantly higher than those with increased Hcy level (P<0 .05) .Conclusion Monitoring the serum Hcy lev‐el change during the PEM chemotherapeutic process in the patients with advanced lung adenocarcinoma may be used in the predic‐tion of the chemotherapeutic effect .

Objective:To investigate the effects of ligamen remnant preservation on knee joint function and proprioception recovery in patients with anterior cruciate ligament (ACL) injuries during ACL reconstruction under arthroscope.Methods:The clinical data of 266 patients with ACL injuries,who were treated in the 174th hospital of PLA from January 2010 to March 2016,were retrospectively analyzed.All the patients underwent ACL reconstruction under arthroscopy,among them,163 patients with remnant preservation were chosen as remnant preservation group;103 patients with completely clearing remnant preservation in the operation,as non remnant preservation group.All the patients were followed up for more than 12 months,and the knee function and proprioception recovery of the two groups were evaluated.Results:There were no significant differences in the knee ipsilateral Lysholm score,international knee documentation committee knee assessment scale (IKDC) score,passive activity detection threshold,passive angle regeneration test results between the two groups before operation,9 and 12 months after operation (P＞0.05).The Lysholm scores and IKDC scores of the two groups at each time point were significantly higher than those before operation,the passive activity detection threshold and passive angle regeneration test results were significantly lower than those before operation (P＜0.05).The Lysholm scores and IKDC scores in the remnant preservation group 3 and 6 months after operation were higher than those in the non remnant preservation group,the passive activity detection threshold and the passive angle regenerated test results were lower than the non remnant preservation group,the difference was statistically significant (P＜0.05).Conclusion:Remnant preservation in the ACL reconstruction under arthroscopy can accelerate the recovery of knee joint function and proprioception,and satisfactory clinical results are achieved,which is worth popularizing.

Objective To discuss the treatment of urethral stricture after hypospadias reDair.Methods Thirty-seven cases of urethral stricture after hypospadias repair from 1999 to 2006 were ret-rospectively analyzed. Of 37 patients,the stricture was located at the distal end of urethra in 7 cases.There were 3 1 cases with anastomotic stricture.There was 1 case with distal urethral stricture and anastomotic structure.There were 1 3 patients with the simple urethral stricture and the complicated 24 cases.Of 13 simple urethral stricture patients,4 patients were repaired with urethro-meatomy,6 patients with shelf operation and 3 patients with transurethral holmium laser urethrotomy.Eight Pa-tients with complicated urethral fistula,6 patients with urethral diverticula,4 patients with phallo-campsis and 6 patients with many times of postoperative urethral stricture were repaired with shelf op-eration or penis skin flap or septum of scrotum skin flaps urethroplasty. Results The simple stric-tures of 1 2 patients were cured by stage 1 operation,the other one cured after second surgery.Of 8 patients with fistula,7 were cured at stage 1,the other one was cured at the stage 2.Of 6 patients with diverticulum,all were cured at stage 1.Of 4 patients with phallocampsis,3 cases were cured at stage 1,the other one was cured at the stage 2.Of 6 patients with recurrent strictures,all were cured at stage 1.A1l patients were followed up 1 2 to 24 months.The micturition was without difficuItv at stand position. Conclusions Urethral stricture is one of the most common complications after hypos-padias repair.The simple urethral stricture could be repaired with urethro-meatomy or sheIf operation or transurethral holmium laser urethrotomy.The complicated urethral stricture could be reDaired with shelf operation or penis skin flaps or septum of scrotum skin flaps urethroplasty and overjetted with dortos of scrotum flaps.

Objective To summarize the success of congenital penile curvature. Methods 401 cases of con-genital penile curvature,whose average age is 2. 5 years ,ranging from 1 year to 26 years old. Of all cases ,383 patients who have both hypespadias and penile cun, ature, only 18 patients are congenital penile curvatures. 295 paitents are slight curvature,85 patients are moderate curvature and 21 patients are severe curvature. Curvature correction was per-formed on a case-by-case basis by solution fibric trabs of ventrial urethra and surrounding,skin de-gloving, ff necessa-ry,dorsal plication,and confirmed by Gittes test. Results . Curvature correction was possible by mobilization of ure-thra after penile degloviag,only a few need dorsal plieation. Followup for 6 months to 2 years,396 patients are success at once. The others after a second surgery had 100% success. Conclusions Solution fibrie trabs of ventrial urethra and surrounding, skin de-gloving, if necessary,dorsal plication ,is the first choice to repair of the congenital penile cur-vature and have good results.

Objective To evaluate the two-stage repair in hypospadias cripples.Methods 35 patients with hypospadias cripples underwent two-stage repair.At the first stage,a full-thickness graft of skin or buccal mucosa was used for urethral plate reconstruction after the release of chordee.The second stage was performed 6 months after completion of the first stage.Tubularization of the replaced urethral plate was the preferred technique.Results There was no urethra stricture or “preplaced urethral plate ” atrophy.Fistula developed in 2 of 35 cases.Conclusion The twostaged technique was a useful strategy to deal with the myriad abnormalities encountered in crippled hypospadias.This technique could not only create a neourethra successfully,but also give the penis a near-normal shape and appearance.