Objective To investigate the urodynamic pattern in infants with no apparent lower urinary tract symptoms. Methods Video cystometry with simultaneous perineal EMG recording was performed in 14 infants (10 male and 4 female,age 2 d to 2.5 months) with congenital renal pelvis dilatation who were screened for potential bladder dysfunction and VUR.No abnormal lower urinary tract was observed at examination. Results The post-voiding residual urine volume was (1.2?0.8)ml.The maximum bladder capacity was (33?24)ml,with voiding efficiency being 0.87?0.17.Detrusor instability occurred in 21%(3/14) of the subjects. The intermittent voiding pattern was observed in 64% (9/14) of the subjects and characterized by one or repeated increase in sphincter activity with simultaneous rise in voiding detrusor pressure curve. The maximum voiding detrusor pressure was (74?24)cmH 2O.The peak voiding detrusor pressure induced by dyssynergia could rise up to more than 100 cmH 2O. Conclusions In infants with no apparent lower urinary tract symptoms,bladder instability is uncommon,but the capacity is lower than the expected normal range.The high voiding pressure is induced by detrusor-sphincter dyssynergia.

ObjectiveTo study the effect of nutritional intervention combined with aerobic exercises on serum adiponectin and insulin resistance in nonalcoholic fatty liver (NAFL) patients.Methods32 patients confirmed as NAFL between April 2008 and August 2009 were enrolled into NAFL group and 31 health people into control group.NAFL group received nutritional intervention and followed aerobic exercise program.The changes of body mass index (BMI),serum adiponectin,fasting blood glucose (FBG),fasting insulin (FINS) and serum lipids were recorded before and after interventions.Insulin resistance index (HOMA-IR) was calculated.Inter-group difference,changes after intervention,and correlation between serum adiponectin and the other indexes were analyzed.ResultsCompared with the control group,BMI [ (29.84 ±3.16) kg/m2 vs.(22.22 ± 1.81 ) kg/m2,P =0.000],total cholesterol (TC) [ (5.09 ±0.86) mmol/L vs.(4.38 ±0.85) mmol/L,P =0.002],triglyceride (TG) [ (1.99±0.86) mmol/Lvs.(1.10±0.38) mmol/L,P=0.000],FBG[ (6.02±0.63) mmol/Lvs.(5.02±0.71) mmol/L,P=0.000],FINS[ (13.73±3.24) mU/Lvs.(9.55±1.99) mU/L,P=0.000],HOMA-IR [ (3.74±1.21) mmol/L vs.(2.08 ±0.27) mmol/L,P=0.000] in the NAFL group were significantly higher,while serum adiponectin in the NAFL group was significantly lower [ (4.89 ± 1.81 ) ug/L vs.( 12.97 ± 3.15 ) ug/L,P =0.000 ].After nutritional intervention and aerobic exercises,BMI [ ( 26.65 ± 2.39 ) kg,/m2 vs.(29.84 ±3.16) kg/m2,P =0.000] 、FBG [ (5.61 ±0.47) mmol/L vs.(6.02 ±0.63) mmol/L,P =0.004 ],and FINS [ ( 11.12 ± 2.01 ) mU/L vs.( 13.73 ± 3.24) mU/L,P =0.000 ] in the NAFL group were decreased significantly,while serum adiponectin [ (6.54 ±2.12) ug/L vs.(4.89 ± 1.81 ) ug/L,P =0.001 ] was significantly higher than the level before intervention.Serum adiponectin was negatively correlated with BMI,FBG,FINS,HOMA-IR,and TG (P =0.004,0.000,0.000,0.000,and 0.010),and positively correlated with high density lipoprotein cholesterol (P =0.026),but not correlated with TC (P =0.101 ).ConclusionThe combination of nutritional intervention and aerobic exercises can improve the level of serum adiponectin,adjust the level of serum glucose and serum lipids,and alleviate insulin resistance in NAFL patients.

Objective To study the relationship between serum adiponection and liver function and insulin level in patients with hepatogenous diabetes.Methods The research subjects included:28 patients with hepatog-enous diabetes who were admitted at Liaocheng People's Hospital (hepatogenous diabetes group);27 patients with simple type 2 diabetes without any complication (simple type 2 diabetes group),and 27 normal controb (control group).Blood adiponectin,fasting blood glucose (FBG),fasting insulins (FINS),alanine aminotransferase (ALT),aspartate transferase (AST),total bilirubin (TBIL) and albumin (ALB) were measured,and according-ly the insulin sensitivity index (ISI) was calculated.Results Compared with the control group.serum adiponec-tin levels and ISI levels were significantly lower in the other two groups (P<0.01),and the adiponectin levels were significantly higher in hepatogenous diabetes group than in simple type 2 diabetes group (P<0.05).The FBG and FINS levels in the hepatogenous diabetes group and the FBG levels in the simple type 2 diabetes group were significantly higher than those in control group (P<0.01).The FINS levels were significantly higher in the hepatogenous diabetes group than in simple diabetes group (P<0.05),while the levels of FBG and ISI were lower than that of simple type 2 diabetes group (P<0.05).Adiponectin levels were negatively correlated with ISI (r= 0.5265,P=0.000),and positively correlated with FBG (r=-0.6040,P=0.000),and were not correlated with liver functions Conclusion Insulin resistance and abnormal metabolism of adipenection exist in patients with hepatogenous diabetes and may together affect the occurrence and development of hepatogenous diabetes.

The urinary continence mechanism in the fetal and neonatal periods is the foundation of the development of continence function in the lower urinary tract (LUT).At present,it is rarely reported what is the fetus and newborns' LUT continence,and the domestic reviews about these knowledge is blank.The authors searched all the research reports about LUT continence and its mechanism in the fetal and neonatal period both in the human and animals,and reviewed the urinary continence of the fetus and newborns at first time at home,to fill the domestic blank of this field.

It is well known that adolescent varicocele is one reason to induce the testicular hypotrophy and potential infertility.Its indication and methods of treatment are controversial.This review provides the recent progress in diagnosis and treatment of adolescent varicocele including the indications and methods of surgical treatment,as well as new information of future researcher in the areas.

Voiding dysfunction is common in children,urodynamic study is necessary to evaluate voiding dysfunction.Recently,urodynamic studies in children with voiding dysfunction have been performed with increasing frequency as the techniques have been applied in most hospitals widely.New technologies,such as ultrasound urine flow in newborns and ambulatory urodynamics monitoring in children,have been used.Urodynamic has been used routinely in children with neurogenic bladder in China.This review summarized the application of urodynamics in children with voiding dysfunction and the relevant terminologies in pediatric urodynamics,in order to provide a reference for clinical applications and researches.

Overactive bladder(OAB) is a clinical syndrome which mainly defined by urinary urgency,and it is mainly diagnosed by clinical manifestations.The pathophysiological mechanisms include detrusor overactive,urethral instability and other neurological or psychiatric factors.Obviously,the dysfunction of detrusor and urethral sphincter can not be diagnosed accurately that consequently affects the treatment significantly by clinical symptoms.Recently,the urodynamic evaluation is recommended for more precise diagnose of OAB.In addition,it has been reported that urinary nerve growth factor and autonomic nervous system function could be used to diagnose OAB in children.The updated techniques diagnosis of OAB in children are summarized in this review.

Congenital lower urinary tract obstruction in the fetus and is rare in neonates,but it is identified in-creasingly in the era of prenatal sonography and resulted in substantial perinatal mortality with lifelong morbidity. Poste-rior urethral valves,urethral atresia,and prune - belly syndrome are the frequently reported causes of lower urinary tract obstruction. Despite the completion of a randomized trial,the benefit of prenatal intervention with vesicoamniotic shunt placement remains unclear. The management of these disease in fetus and newborns requires appropriate urinary tract decompression,subspecially support,and definitive diagnosis with endoscopy and radiography. Now,the recent progress of diagnosis and treatment of congenital lower urinary tract obstruction were reviewed.

Objective To investigate the urodynamic measurements in later pregnant women with urinary incontinence. Methods According to the symptoms, a total of 63 volunteers in later pregnancy were divided into two groups including urinary incontinence group and no symptom group. Fourteen women who were married but not delivered were included in control group. Urodynamic study was performed on all women. Results The occurrence rate of urinary incontinence in later pregnancy was 26.98%. The valsalva leak point pressure only occurred on two pregnant women were 50 cmH2O and 67 cmH2O respectively. Compared with the no symptom group, the maximum urethral closure pressure[(83.69±42.55)mmHg vs(108.09±34.95)mmHg, P＜0.05])and the functional urethral length [(30.45±8.42)mm vs (37.60±18.45)mm ,P＜0.05]of urinary incontinence group were decreased obviously. Conclusions The main reason of urinary incontinence in pregnancy was that the maximum urethral closure pressure could not sufficiently increase to compensate for the progressive increase in bladder pressure during pregnancy and functional urethral length could not correspondingly increase along with the pregnancy.

Objective To observe the serum inflammatory factors level in patients with obstructive sleep apnea syndrome (OSAS) and coronary heart disease (CHD).Methods Venous blood was collected at 6 AM from 53 natiems with both OSAS and CHD and 37 simple snorers following a full night polysomnography (PSG) test.Serum MMP-9、TIMP-1 test were conducted.Results MMP-9,TIMP-1 level in patients with OSAS and CHD was significantiv higher than that of the simple snorers (P<0.05).Conclusion serum MMP-9 and TIMP-1 level increase in patients with OSAS and CHD.It is suggested that elevated level of serum MMP-9 and TIMP-1 might play an important role in the development of CHD in patients with OSAS.