Objective: To evaluate the clinical outcome of botulinum A toxin (BTX-A) injection into external sphincter combined with oral baclofen in treatment of detrusor-external sphincter dyssynergia (DESD) after spinal cord injury (SCI). Methods: A total of 38 urodynamic examination-confirmed DESD patients, male 31 and female 7, with an average age of (36.5 ± 17.8) years old, were included in this study. 200 U of BTX-A toxin was dissolved in 8 ml of normal saline and the solution was injected at 8 different sites (1 ml per site) of the external sphincter via a 5F flexible cystoscopic needle. On the second day, 9 patients (BTX-A + baclofen group) were randomly selected for baclofen oral administration, 3/d for 3 months, the other 26 patients were taken as control. Urodynamic examination was repeated in all patients 4 weeks later; the voiding diary and urodynamic outcomes were compared before and after treatment. The adverse and toxic effects were observed in the patients who were followed up for 2-9 months. Results: One month after treatment the voiding and storing functions of bladder were improved to different degrees, with the mean maximum uroflow rate (Qmax), the mean urine volume, the mean maximal eystometric capacity and the bladder compliance increased significantly and the mean postvoid residual urine volume and the mean maximal voiding pressure decreased significantly (all P

Objective: To summarize our experience on 164 cases of retroperitoneoscopic nephrectomy and to analyze the clinical outcomes of retroperitoneoscopic nephrectomies. Methods: From October 1998 to July 2006, a total of 164 patients (91 males and 73 females; age range 2-80 years, mean age [49.5±25.7] years) have undergone retroperitoneoscopic nephrectomies in our department, with 95 undergoing radical renal cancer resection and 69 undergoing simple nephrectomies. Fifteen renal cancer patients visited doctors due to painless hernaturia and the rest 80 were detected during physical examination. The tumors were averagely (4.3 ± 1.2) cm (range 1.0-8.0 cm) in diameter, with 40 at T1N0M0 stage, 47 at T2N0M0 stage, and 8 at T3aN0M0 stage. Among the 69 simple nephrectomy cases, 3 were kidney atrophy, 46 were kidney dropsy, 3 were kidney maldevelopment, and 7 were kidney tuberculosis. All the kidneys were confirmed to have no function by radiological renal pictures. Results: The operative time was 25-180 min (mean, [53.5 ± 27.2] min) and the blood loss was 20-1 500 ml (mean, [150 ± 66] ml). Three cases were converted to open operations. The average hospital stay was (8.0 ± 4.4) days. Three renal cancer patients died of metastasis during a follow-up of 1-90 months and all the other patients survived. Conclusion: Retro entoneoscopic nephrectomy, with shorter operative time and quicker postoperative recovery, is a practical surgical procedure.

Objective: To investigate the influence of sirolimus on the disease progression of a rat model of autosomal dominant polycystic kidney disease (ADPKD) - Han : SPRD with chronic renal insufficiency. Methods: Twenty 6-month-old male ADPKD heterozygous (Cy/+) rats with chronic renal insufficiency were divided into 2 groups at random (n=10). Rats in experimental group received intragastric administration of sirolimus (0.2 mg · kg-1 · d-1) for 45 days and those in control group were bred routinely. The general state and renal function of rats were monitored throughout the treatment. The rats were sacrificed 45 days later and both kidneys were harvested, weighed; and the 2-kidney/ total body weight (2K/TBW) ratio was determined. Then the kidneys were subjected to immunohistochemistry examination and the numbers of cells positive of proliferating cell nuclear antigen (PCNA) were counted. Results: There was no death in the 2 groups and all rats gained weights, with no significant difference between the 2 groups, Blood urea nitrogen (BUN) increased progressively in both groups, with the increase in experimental group lower than that in the control group by 12.5 % on 45 days after administration (P<0.05). The 2-kidney-weight and 2K/TBW ratio in experimental group was lower by 11.8 % (P<0.05) and 7.1 % (P<0.01) than those in the control group, respectively. Renal enlargement and cystogenesis were inhibited by sirolimus, with the number of PCNA-positive cells per cyst being 0.23±0.11 in experimental group and 0.47±0.24 in the control group (P<0.05). Conclusion: Sirolimus can slow down the disease progression in Han: SPRD rats with ADPKD, even though they had been in a condition of renal insufficiency.

Objective: To investigate the differential expression of matrix metalloproteinases-1/tissue inhibitor of metalloproteinase-1 (MMP-1/ TIMP-1) between normal kidney, kidneys of patients with autosomal dominant polycystic kidney disease (ADPKD), and the original kidneys after renal transplantation (OKRT). Methods: DNA microarray technique was used to analyze the differential gene expression in the above 3 tissues. Semi-quantitive RT-PCR was performed to verify the differentially expressed genes. Results: There were 463 differentially expressed genes between normal kidney and ADPKD tissues and 130 differentially expressed genes between ADPKD and the OKRT tissues. Expression of MMPI/TIMP1 in the ADPKD and the OKRT tissues were significantly higher than that in the normal kidney tissue (P<0.05), with no significant difference found between the former 2 groups. Results of RT-PCR were consistent with the microarray findings. Conclusion: The pathogenesis of ADPKD may be related with the high expression of MMPs/TIMPs and the inhibitor of MMPs may have therapeutic effect on ADPKD.

Objective: To study the differential gene expression pattern between autosomal dominant polycystic and normal kidney tissue, and to deduce the etiological factor and treatment for autosomal dominant polycystic kidney disease (ADPKD). Methods: The cDNA probes were prepared by label ling normal kidney tissue mRNA and ADPKD tissue mRNA with Cy3-dUTP and Cy5-dUTP separately through reverse transcription. The probes were then hybridized with the DNA microarrays (PCR products of 4 096 human cDNAs onto specially treated glass slides) and the fluorescent signals were scanned with ScanArray 4000 scanner. Semi-quantitive RT-PCR was performed to test the expression level of 4 related genes. Results: Of the 4096 genes screened, 463 genes showed obvious changes. Expression of 206 genes was upregulated in the polycystic kidney tissue, especially cyclin D2, MMPs, TIMP1 and fibroblast activation protein; expression of 257 genes was downregulated, especially phosphatase 1A and acid phosphatase 1. The expression of genes tested by RT-PCR was in accordance with those detected by cDNA microarray. Conclusion: ADPKD may be related to the upregulation of cyclin,MMPs,and various kinds of growth factors, and drugs like inhibitors of CaM and MMPs might have therapeutical effects on ADPKD.

Objective:To investigate the clinical and neuroimaging features of atypical teratoid/rhabdoid tumors (AT/RT) of the central nervous system and the survival prognosis in different locations.Methods:The clinical data of 27 patients with AT/RT confirmed by biopsy or postoperative pathology in Sanbo Brain Hospital of Capital Medical University from October 2012 to September 2020 were collected, including 17 males and 10 females, aged (7.6±10.0) years, ranging from 0.2 to 39.0 years old.The clinical features and the results of the first preoperative imaging examination were retrospectively analyzed.The patients were divided into supratentorial, infratentorial and trans supratentorial and infratentorial groups according to the location.The survival time of the three groups was compared by Kaplan-Meier survival curve.Results:All patients presented with headache, including 12 cases with vomiting.There were 12 cases of supratentorial, 10 cases of infratentorial and 5 cases of supratentorial and infratentorial.There were 20 cases of cystic degeneration, 7 cases of calcification, 6 cases of hemorrhage and 13 cases of peritumoral edema.The median survival time of patients with infratentorial AT/RT was longer than that of patients with supratentorial and transtentorial AT/RT (χ 2=7.353, P=0.025). Conclusion:Central nervous system AT/RT is easy to occur in young children, and the survival time of AT/RT patients is longer.

Objective To investigate the quality of life and analyze related factors of all the disabled at the entry of the Home Service Program in Zhabei district, Shanghai. Methods All the disabled were surveyed using the Chinese version of Short-Form 36 Health Survey(SF-36). Results 280 disabled people finished the survey, the total score was (59.72±20.03). There were significant differences in the scores among different ages, types of disabilities and status of subsistence allowances (P<0.01). The age was negatively correlated with quality of life (P<0.01). The education degree and the status of subsistence allowances were positively correlated with quality of life (P<0.05, P<0.01).Conclusion People with disability have poor quality of life in Zhabei district, Shanghai.

Objective To lessen the learning curve of percutaneous renal lithotripsy(PCNL),we introduced a novel ex-vivo learning and training model for PCNL under fluoroscopy and ultrasonography-guided access. Methods The model was set up nailing an adult porcine kidney with＞3 cm ureter (freshly removed from the slaughtering factory),with a full thickness flap of the thoracic wall or abdomen wall with two ribs,to a board.The porcine kidney was placed within the flap with the catheterized ureter outside.The kidney was enclosed by the flap so as to create a roodel for percutaneous renal surgery;with the ribs overlying the upper portion of the kidney.The model was fixed to the board by two nails.Artificial stone material was implanted in the renal pelvis.Fluoroscopy guidance access:Retrograde pyelography via injection of contrast medium into the ureteral catheter images the collecting system. After the long axis of the target calyx is identified,the C-arm is rotated 30 degrees toward the surgeon,placing the C-arm axis in the same posterior plane of the kidney.The needle is advanced in the plane of the fluoroscopic beam,and the appropriate needle placement is determined by obtaining a bull's-eye sign on the fluoroscope screen. Rotating the C-arm to a vertical position monitors the depth of the needle penetration. Ultrasonography guidance access:The renal pelvis can he filled with normal saline through a catheter to simulate hydronephrosis and the target calyx is identified under ultrasonography guidance.The tract dilation and stone disintegration were followed.After training,the kidney can be opened to examine the target calyx and the complication of dilation. Results Altogether,126 urologists attended a urologic endoscopic technique training course.Of the 126 trainees,104 (82.5%) successfully performed the whole percutaneous procedure.At the end of training,114 (90.5 %) of the 126 attendees rated the porcine kidney model for simulation of percutaneous renal surgery as very helpful or helpful.Conclusions This biological training model simulates realistically the clinical procedure of PCNL with respect to trainee experience in a low stress environment that provides an opportunity for repetitive performances in order to learn basic technical skills for the clinical procedure of PCNL in the future.

Objective:To evaluate the clinical outcome of botulinum A toxin(BTX-A)injection into external sphincter combined with oral baclofen in treatment of detrusor-external sphincter dyssynergia(DESD)after spinal cord injury(SCI). Methods:A total of 38 urodynamic examination-confirmed DESD patients,male 31 and female 7,with an average age of (36.5?17.8)years old,were included in this study.200 U of BTX-A toxin was dissolved in 8 ml of normal saline and the solution was injected at 8 different sites(1 ml per site)of the external sphincter via a 5F flexible cystoscopic needle.On the second day,9 patients(BTX-A+baclofen group)were randomly selected for baclofen oral administration,3/d for 3 months; the other 26 patients were taken as control.Urodynamic examination was repeated in all patients 4 weeks later;the voiding diary and urodynamic outcomes were compared before and after treatment.The adverse and toxic effects were observed in the patients who were followed up for 2-9 months.Results:One month after treatment the voiding and storing functions of bladder were improved to different degrees,with the mean maximum uroflow rate(Qmax),the mean urine volume,the mean maximal cystometric capacity and the bladder compliance increased significantly and the mean postvoid residual urine volume and the mean maximal voiding pressure decreased significantly(all P

AIM:To comparatively analyze the effect of wavefront aberration or corneal topography guided laser-assisted in situ keratomileusis (LASIK) on the visual quality in patients with myopia after surgery. METHODS: During the period of January 2016 to January 2017, 100 patients (a total of 200 affected eyes) with myopia in our hospital were selected as the subjects, and they were randomly divided into Group A and Group B with 50 cases in each group. Before surgery, the eyes were examined and LASIK was performed. During surgery,the corneal stroma of eyes in Group A was cut individually according to the results of wavefront aberration examination while the individual cutting in Group B was performed according to the data of corneal topography. The visual acuity and visual quality were compared between the two groups after surgery. RESULTS: There was no significant difference of the visual acuity between the two groups before surgery (P>0.05). The Log MAR uncorrected visual acuity (UCVA), Log MAR BCVA and diopter were significantly improved at 6mo after surgery (P<0.05), and the diopter of Group A at 6mo after surgery was lower than that of Group B (P<0.05). There was no significant difference of contrast sensitivity (CS) between the two groups before surgery (P>0.05). But CS of different optotypes in two groups at 3mo after surgery were all better than those before surgery (P<0. 05). There was no significant difference between the two groups in CS under the bright and non-glare condition at 3mo after surgery (P>0.05). However, CS of Group A under bright glare, dark with glare and dark without glare states were significantly better than those of Group B (P<0. 05). There was no significant difference of detection results of wavefront aberrations between the two groups before surgery(P>0 05). At 3mo after surgery, the total aberrations, total higher-order aberrations,comatic aberrations and spherical aberrations significantly increased in two groups (P<0.05), and the increase in Group A was obviously lower than that in Group B (P<0.05). CONCLUSION: Both of wavefront aberration and corneal topography guided individualized excimer surgery can significantly improve the visual acuity of patients with myopia, but the former has more advantages in improving the visual quality.