Objective To investigate the clinical pathological features of IgA nephropathy with nephrotic syndrome and risk factors for impairment of renal pathology.Methods 121 cases of IgA nephropathy with nephrotic syndrome were selected,all patients had been diagnosed with biopsy.The clinical pathological features wer analyzed, they were divided into two groups according to different kidney disease.The minor pathological changes which Leeˊs classification grade Ⅰ and grade Ⅱ patients belong to group A,with a total of 36 cases,while Leeˊs pathology heavier grade for grade Ⅲ,Ⅳ and Ⅴ grade level in patients belonging to group B,with a total of 85 cases.Clinical character-istics and clinical laboratory indicators of two groups were compared,and risk factors for renal pathological damage were analyzed in multivariate analysis.Results The average duration of group B was significantly longer than the average duration of group A,the difference was statistically significant (t =12.74,P <0.05).Mean arterial pressure of group B was significantly high than that of group A,the difference was statistically significant (t =5.31,P <0.05).Patients with hypertension,urinary erythrocytes with full vision and renal failureof group B were significantly more than those in group A,the differences were statistically significant (χ2 =14.29,9.74,8.26,all P <0.05).Total cholesterol and 24 h urinary protein excretion of group B were significantly lower than those in group A,the differences were statistically significant (t1 =8.75,t2 =6.73,all P <0.05).Serum albumin and hemoglobin levels of group B were significantly higher in group A,the differences were statistically significant (t3 =7.42,t4 =9.15,all P <0.05). Multivariate Logistic regression analysis showed,in IgA nephropathy with nephrotic syndrome,hemoglobin was a protective factor,the mean arterial pressure,24h urinary protein of red blood cells and microscopic urine >5.0 ×107 /Lwere dangerous aggravating factors.Conclusion Hemoglobin protective factors for IgA nephropathy with nephrotic syndrome,the mean arterial pressure,24h urinary protein excretion and urine red blood cells are their risk aggravating factors,they can make a more accurate judgment of the patientˊs condition.

Considering that antibiotic treatment may elevated the level of prostate-specific antigen (PSA) and hence limit the specificity of PSA test for prostate cancer, urologists use empiric antibiotic treatment for men with increased PSA levels. But it is controversial whether antibiotic treatment can exclude inflammation in the differential diagnosis of PSA elevation. Some researchers have found that antibiotic treatment can decrease inflammation-induced PSA elevation and help to reduce unnecessary biopsies, while others have reported that antibiotic treatment has no significant effect on the PSA level, and the lowered level of PSA following antibiotic treatment does not mean the decreased risk of prostate cancer. Further researches are needed to confirm the value of antibiotic treatment before biopsy.
Anti-Bacterial Agents ; therapeutic use ; Biomarkers, Tumor ; blood ; Biopsy ; Diagnosis, Differential ; Humans ; Inflammation ; metabolism ; pathology ; Male ; Prostate ; pathology ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; diagnosis ; pathology ; Prostatitis ; pathology

Objective?To evaluate the application of two kinds of retroperitoneal laparoscopic nephroureterectomy in upper urinary tract urothelial carcinoma and select the best operative approaches.?Methods?The clinical data of 40 cases of retroperitoneal laparoscopic surgery in patients with upper urinary tract tumor were analyzed. Among the 40 patients, 21 cases (14 males and 7 females) underwent modified retroperitoneal laparoscopic nephroureterectomy combined with transurethral incision of the ureteral orifice (group A), and 19 cases (13 males and 6 females) underwent retroperitoneal laparoscopic nephroureterectomy combined with hypogastrium minor incision and transurethral incision of the ureteral orifice (group B). The operative time, the blood loss, the retention time of drainage tube, the first exhaust time of postoperative and the hospital stay were compared between the two groups.?Results?The operation was successfully completed in all the 40 cases without conversion to open surgery. The operative time in group A was significantly shorter than that in group B (P < 0.01), and the hospital stay was significantly shorter than that in group B (P < 0.05). There were no statistical differences in blood loss, the retention time of drainage tube, and the first exhaust time of postoperative between the two groups (P > 0.05).?Conclusions?Compared with the retroperitoneal laparoscopic nephroureterectomy combined with hypogastrium minor incision, the modified retroperitoneal laparoscopic nephroureterectomy is safe and effective, which can shorten the operative time and reduce hospital saty. Tumor located in renal pelvis and the proximal &middle part of ureter, modified retroperitoneal laparoscopic nephroureterectomy combined with transurethral incision of the ureteral orifice is the most effective method.

OBJECTIVETo investigate seminal parameters in noninflammatory chronic prostatitis/chronic pelvic pain syndrome (CAP III B).

METHODSA total of 74 consecutive cases of patients who had been diagnosed as CAP III B and 46 cases of controls were included in the study. Severity of symptoms in men with CAP III B was defined according to the NIH Chronic Prostatitis Symptom Index (NIH-CPSI). All of them underwent a 'four glass-test' including leukocyte determination in expressed prostatic secretions (EPS), voided urine after prostatic massage (VB3) and ejaculate semen followed by analysis according to WHO. The analysis included seminal volume, pH, duration of liquefaction, sperm density, vitality, motility(a + b) and morphology. Correlations between the duration or the severity of symptoms and spermiogram results in patients with CAP III B were assessed respectively.

RESULTSThe CAP III B group and the control group differed significantly in ejaculate volume, duration of liquefaction and motility, while the remaining parameters did not differ significantly. The duration of chronic pelvic pain showed apparently positive correlationship with liquefaction time, while the symptom duration negatively correlated with sperm motility. The NIH-CPSI score had no significant relationship with seminal volume, duration of liquefaction and sperm motility.

CONCLUSIONOur results indicate that CAP III B can have a significant negative impact on sperm volume, liquefaction and motility. Our data also supports the results that the longer the duration of symptoms, the more influences on semen liquefaction and motility might be.

Adult ; Case-Control Studies ; Chronic Disease ; Humans ; Male ; Middle Aged ; Pelvic Pain ; Prostatitis ; physiopathology ; Semen ; chemistry ; Sperm Count ; Sperm Motility

OBJECTIVETo investigate the protective effects of allopurinol (ALLO) on white matter damage in premature rats.

METHODSAn animal model for white matter damage was established by bilateral carotid artery occulation (BCAO). Eighty-four newborn SD rats (1 day old) were used in this study and were divided randomly into three groups [sham surgery (Sham); BCAO group (BCAO); allopurinol-treated group (ALLO)]. Pathological changes were studied 7 days and 14 days after BCAO, respectively. Myelin basic protein (MBP) was detected by immunohistochemistry 7 days and 14 days after BCAO, respectively. MBP-mRNA expression was determined 7 days and 14 days after BCAO respectively by reverse transcription-polymerase chain reaction (RT-PCR) with fluorescent quantitative method.

RESULTSIn BCAO group, mild or severe rarefaction was found in 10 cases in the corpus callosum area, especially at the cingulum. Pathological changes of white matter were found in 4 cases in internal capsule. Subcortex white matter rarefaction was found in 8 cases. The extent of white matter rarefaction in ALLO group was reduced significantly. Enlargement of bilateral ventricles was found in 6 of 8 cases in BCAO group. The average ventricle size in ALLO group (2.44 +/- 0.71)% was reduced significantly as compared with that in BCAO group (3.27 +/- 0.73)% (P < 0.05). Strong MBP positive staining was found in sub-cortex, corpus callosum, hippocampus gyrus, and internal capsule of P14 sham surgery group. In BCAO group the MBP staining extent was reduced. The extent of MBP staining of ALLO group was between the other two groups. The optical density (OD) of MBP positive staining in BCAO group (6.60 +/- 0.68) was found higher than that in sham surgery group (9.40 +/- 0.53), the difference was statistically significant (P < 0.05). Compared with BCAO group, OD value in ALLO group (7.10 +/- 0.18) increased significantly (P < 0.05). RT-PCR data showed that MBP-mRNA copies (log10) in P7 and P14 rats of both BCAO and ALLO groups were lower than that in sham surgery group (P < 0.01); However, MBP-mRNA copies in ALLO group were higher than that in BCAO group (P < 0.05).

CONCLUSIONSBCAO could be used in newborn rats (1 day old) to establish a premature white matter damage (WMD) animal model. Allopurinol may have a potential protective effect on premature SD rat with ischemic WMD.

Allopurinol ; pharmacology ; Animals ; Animals, Newborn ; Brain ; drug effects ; Brain Diseases ; metabolism ; pathology ; prevention & control ; Disease Models, Animal ; Immunohistochemistry ; Myelin Basic Protein ; genetics ; metabolism ; RNA, Messenger ; genetics ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction

AIMTo assess the efficacy and safety of anal submucosal injection (ASI) of amikacin in chronic bacterial prostatitis (CBP).

METHODSFifty male outpatients with CBP were randomly divided into two groups. Thirty cases of ASI group were given amikacin 400 mg daily by ASI for ten times and the other twenty cases of intramuscular injection (IM) group were given the same drug daily by IM. All patients were evaluated with NIH-Chronic prostatitis symptom index (NIH-CPSI), the bacteria culture of the expressed prostate secretion (EPS), proctoscopic examination, rectal biopsy and the clinical manifestation were checked at pretreatment and on day 7 and 90 after cessation of therapy.

RESULTSThe cure rate, apparent effective rate and effective rate of ASI group and IM group were 33.3% vs 5% (P<0.05), 43.3% vs 10% (P<0.05) and 16.7% vs 20% (P>0.05), respectively. The score of NIH-CPSI in both of ASI group and IM group decreased significantly 7 days after cessation of therapy, both ASI and IM of amikacin could relieve symptoms within a short time. However, 3 months after cessation of therapy the score of NIH-CPSI in ASI group continued down in spite of no significant differences compared with 7 days after cessation of therapy, but the score of IM group was rebound nearly closed to level of pretreatment at 23.8 8.5 and significantly higher than that of ASI group. The amount of white blood cell (WBC) of EPS in ASI group increased slightly at 7 days after cessation of therapy without significant difference with pretreatment (P>0.05), but it significantly decreased at 3 months after cessation of therapy, the amount of WBC of EPS in ASI group was lower than that of IM group at 3 months after cessation of therapy (P<0.05). Proctoscopic examination of anal canal were normal after ASI therapy and the rectum biopsy showed no obvious histopathologic abnormality at the site of injection except mild focal submucosal infiltration of lymphocytes and plasma cells at 7 days after cessation of therapy which disappeared on 3 months after cessation of therapy. All patients had no evident complications.

CONCLUSIONASI could be recommended as a new safe, effective, painless method of antibiotics administration in the treatment of CBP.

Adult ; Amikacin ; administration & dosage ; adverse effects ; Anal Canal ; cytology ; Anti-Bacterial Agents ; administration & dosage ; adverse effects ; Biopsy ; Gram-Negative Bacterial Infections ; drug therapy ; Humans ; Injections ; methods ; Male ; Middle Aged ; Mucous Membrane ; Prostatitis ; drug therapy ; microbiology ; Treatment Outcome

OBJECTIVETo study whether N, N'-di-(m-methylphenyi)-3,6-dimethyl-1,4-dihydro-1,2,4,5-tetrazine-1,4-dicarboamide (ZGDHu-1) inhibits proliferation and induces apoptosis in human lung carcinoma cell line EBC-1 cells and its molecular mechanism.

METHODSDifferent concentrations of ZGDHu-1 and different times of culture were used to treat EBC-1 cells in vitro. The inhibition of proliferation was measured by BrdU-ELISA. Cell apoptosis was detected by Annexin V/PI staining and cellular DNA fragmentation ELISA. Phosphorylated p38MAPK and STAT3 were examined by flow cytometry. The protein expressions of bcl-2, bax, p53, Fas, and caspase-3 were detected by Western blot analysis.

RESULTSZGDHu-1 inhibited EBC-1 cell proliferation within a certain range of treating times and does, with a 24 h IC(50) of (295 ± 25) ng/ml, 48 h of (112 ± 8) ng/ml and 72 h of (23 ± 2) ng/ml. The EBC-1 cell apoptosis was confirmed by Annexin V/PI labeling and cellular DNA fragmentation ELISA in a dose-related manner. When EBC-1 cells were treated with 50, 200, and 500 ng/ml ZGDHu-1 for 48 h, the expression rates of phosphor-p38MAPK protein were 67.4%, 88.2%, 91.1%, respectively, and that of the control was 10.6%. That of STAT3 protein were 56.5%, 43.6% and 34.6%, respectively, and that of the control was 89.1%. The expression of bax, p53 and Fas protein was significantly increased, that of bcl-2 was not changed, and that of caspase-3 was significantly decreased by the ZGDHu-1 treatment.

CONCLUSIONZGDHu-1 can inhibit proliferation and induce apoptosis in EBC-1 cells. The mitochondrial pathway mediated by Fas may be one of its mechanisms. The apoptosis of EBC-1 cells may associate with up-regulation of phosphor-p38MAPK and down-regulation of phosphor-STAT3 in the cells.

Apoptosis ; drug effects ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Caspase 3 ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; DNA Fragmentation ; Heterocyclic Compounds, 1-Ring ; administration & dosage ; pharmacology ; Humans ; Lung Neoplasms ; metabolism ; pathology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; STAT3 Transcription Factor ; metabolism ; Tumor Suppressor Protein p53 ; metabolism ; bcl-2-Associated X Protein ; metabolism ; fas Receptor ; metabolism ; p38 Mitogen-Activated Protein Kinases ; metabolism

As the important external genitalia of males, penis has the functions of both urination and copulation. Battle wound, other trauma, and some diseases such as penile cancer can result in total and partial penile defect, which has great impact on the sufferers' mind and life. Therefore, the treatment of penile defect is receiving more and more importance from both the patients and doctors. The ideal treatment is expected to achieve a satisfactory appearance, unobstructed standing urination and successful copulation. Nowadays, the main clinical techniques for the treatment of penile defect include penile replantation, penile lengthening, and penile reconstruction. The progress made in transplantation immunity, tissue matching, immunosuppressive agents, and long-term surviving of animal allograft limb transplantation has prepared a firm ground for human penile allograft. The construction of penile tissues by tissue engineering techniques is still at the experimental stage. It would be a valuable research how to assimilate the constructed and autologous tissues in clinical practice so as to achieve better function and appearance of the penis.
Humans ; Male ; Penile Prosthesis ; Penis ; injuries ; surgery ; Reconstructive Surgical Procedures ; methods ; Replantation ; methods ; Surgical Flaps ; Tissue Engineering

OBJECTIVETo explore the clinical value of determination of ATP levels in CD4(+) cells of patients with cytomegaloviral pneumonia after kidney transplantation.

METHODSTwenty-eight patients with cytomegaloviral pneumonia following kidney transplantation and 30 healthy volunteers were enrolled in this study. ATP-bioluminescence assay (ATP-CVA) was used to assess the immune response of CD4(+) cells to phytohemagglutinin (PHA) stimulation in the normal volunteers and the recipients (before and at 1, 2, and 4 weeks after renal transplantation, before and at 2 and 4 week after the treatment).

RESULTSATP concentration in CD4(+) cells of the recipients was 402-/+58 ng/ml before the operation, significantly lower than that in normal volunteers (458-/+196 ng/ml, P<0.05), and reached the lowest level in the first week after operation especially in the recipients with antibody-inducing therapy; ATP level increased slowly since week 2 post-operation, but still remained significantly lower than the preoperative by the fourth week (266-/+87 ng/ml, P<0.05), especially in the recipients receiving antibody-inducing therapy. In the event of cytomegaloviral pneumonia, ATP level underwent a mild reduction to 152-/+78 ng/ml in comparison with the postoperative level at the first week (P>0.05), and was significantly lower than preoperative level (P<0.01); the decrease was especially obvious during the exacerbation of the condition. ATP level then increased slowly after effective treatment, but was still lower than the preoperative level at 4 weeks after the operation (336-/+92 ng/ml, P<0.05).

CONCLUSIONThe determination of ATP level in CD4(+) cells allows more accurate assessment of the cellular immunity in the renal transplant recipients with cytomegaloviral pneumonia to help in the clinical treatment of the patients.

Adenosine Triphosphate ; blood ; Adult ; Aged ; CD4-Positive T-Lymphocytes ; metabolism ; Case-Control Studies ; Cytomegalovirus Infections ; immunology ; Female ; Humans ; Kidney Transplantation ; Male ; Middle Aged ; Pneumonia, Viral ; immunology ; metabolism ; virology ; Postoperative Complications ; immunology ; metabolism ; Young Adult

OBJECTIVETo evaluate a modified Mitchell's technique for epispadias repair.

METHODSThree patients with epispadias were undergoing the treatment. It was performed to form a penile pedicled flap or scrotal mediastinum flap for the repair of the urethra and the urine was drained through a perined "U" shaped stent.

RESULTSAll of the patients were successfully treated in one-stage with a good appearance and a matching opening of the urethra.

CONCLUSIONThe above mentioned technique could be a good method for epispadias repair.

Drainage ; Epispadias ; surgery ; Humans ; Male ; Penis ; surgery ; Stents ; Surgical Flaps ; Urethra ; surgery ; Urologic Surgical Procedures, Male ; methods