1.Urodynamic research on orthotopic continent globular Ileal bladder
Zongliang ZHANG ; Rongxiang ZHOU ; Monong LI ; Zetao LIU ; Shuai WU ; Haiyan JI ; Yanlun ZHANG
Chinese Journal of Urology 2010;31(9):608-610
Objective To evaluate the urodynamic and functional characteristics of 26 patients who had underwent orthotopic contient globular ileal neobladder. Methods The clinical date of 26patients who underwent radical cystectomy were reviewed. The neobladder pressure, capacity, urethral pressure and urinary flow rate were collected at 3-12 months after operation. Results The neobladders average pressure was less than 15 cm H2O when the volume was 400 ml. The pressure was 22.4 cm H2O at 100% capacity. The mean pressure of contractions was less than 40 cm H2O. The mean filling pressure after operation was relative stable while the difference between 3 months and 6 months was statistically significant. The difference between 6 and 9 and 12 month showed no statistical significance. The mean post-void residual was 42 ml. A mean voiding flow rate of 19. 6 ml/s could be obtained by Valsalva. Conclusion The neobladder not only could offer adequate capacity at low pressures but also could give a satisfied continent.
2.Long-term outcome of female orthotopic ileal neobladder
Rongxiang ZHOU ; Zongliang ZHANG ; Monong LI ; Haiyan QI ; Yanlun ZHANG ; Rongchen YANG ; Shuai WU ; Yan ZHANG ; Gang ZHANG ; Boquan YAN
Chinese Journal of Urology 2008;29(12):818-821
Objective To evaluate the clinical application of female orthotopic ileal neobladder.Methods Modified radical cysteetomy plus orthotopic ileal neobladder was performed on 19 female pa-tients with bladder cancer from June 1999 to January 2008.The mean age of the patients was 52(45-66) years,mean course of disease was 4.4 months (16 days-1.9 years).Of all the patients,there were 10 cases with grade 1,7 cases with grade 2 and 2 cases grade 3.According to the UICC stage system,5 patients were T1 stage,12 T2 and 2 T3a.All the patients received modified radical cystecto-my without resection of uterus and anterior vagina,meanwhile the nerves around urethra were protec-ted.0.8-1.2 cm proximal end of the urethra was excised and 30 cm distal ileum was used for the re-construction of the neobladder.Results Sixteen cases were followed up for 6-102 months,mean 71 months.Fifteen patients survived without disease recurrence,1 patient died of myocardial infarc-tion 17 months postoperation.The daytime and night continent rate was 100$,93% at 9 months postoperative.The average voiding volume of the 15 patients was 519.0 ml.The average residual vol-ume was 29.2 ml,and Qmax was 18.6 ml/s.The average filling and voiding pressure was 16.7 cm H2O and 53.0 cm H2O.Intravenous urography showed slight hydronephrosis in 1 case.Conclusion Female orthotopic ileal neobladder could be a good choice because of the continence,fewer complica-tions,lower pressure and enough bladder capacity.
3.The prognosis of stroke patients with hypertension and its related factors based on a one-year follow-up
Qiong LUO ; Xin HUANG ; Ting LI ; Yanlun ZHOU ; Huan CHEN ; Ping DENG ; Hebin XIE
Chinese Journal of Geriatrics 2020;39(11):1269-1273
Objective:To investigate the prognosis and related factors of stroke patients with hypertension after a one-year follow-up, in order to provide evidence for early clinical identification and intervention of high-risk groups.Methods:A total of 719 stroke patients with hypertension who were hospitalized in our hospital from April 2017 to August 2018 were enrolled as the research subjects.General information, history of underlying diseases, family history, drug treatments and laboratory test results were collected.Patients were followed up for 1 year.Patients were divided into the death group and the survival group according to prognosis.Logistic regression analysis was used to identify risk factors for death in stroke patients with hypertension.Results:A total of 77 patients died during the follow-up period, and the mortality rate was 10.7%(77/719). Univariate analysis showed significant differences in marital status( χ2=35.455, P<0.001), education level( χ2=35.238, P<0.001), exercise habits( χ2=10.172, P=0.001), BMI( t=2.161, P=0.031), age( t=-5.976, P<0.001), history of heart disease( χ2=5.064, P=0.024), antiplatelet use( χ2=14.275, P=0.003), antihypertensive drug treatment( χ2=14.597, P<0.001), lipid-lowering drug treatment( χ2=11.311, P=0.001), and creatinine( t=-4.63, P<0.001)between the death group and the survival group.Logistic regression analysis showed that age( OR=1.042, 95% CI: 1.011-1.073), loss of a spouse( OR=3.674, 95% CI: 1.558-8.665), education level( OR=0.418, 95% CI: 0.225-0.779), use of aspirin( OR=0.376, 95% CI: 0.165-0.855), use of clopidogrel( OR=0.451, 95% CI: 0.219-0.928), antihypertensive drug treatment( OR=0.505, 95% CI: 0.282-0.901)and creatinine( OR=1.009, 95% CI: 1.004-1.014)were independent influencing factors for prognosis( P<0.05). Conclusions:The mortality rate is high in stroke patients with hypertension.Advanced age, loss of a spouse and high creatinine level are risk factors for prognosis, whereas high education level, antihypertensive drug treatment and antiplatelet use are protective factors for prognosis.