1.Continence-preserving radical retropubic prostatectomy
Yiran HUANG ; Dongming LIU ; Wei XUE ; Al ET
Chinese Journal of Urology 2000;0(01):-
Objective To explore the surgical approach of reducing the incontinence after radical retropubic prostatectomy with recent anatomic findings. Methods Sixteen patients with stage B prostate carcinoma received continence preserving anatomic radical retropubic prostatectomy. Results All the patients were followed up 3 months to 5 years,mean 13 months.Thirteen patients had normal voiding,two with mild stress incontinence.Only one was complicated with serious incontinence. Conclusions Identifing and preserving the external striated urethral sphincter and its innervation in performing anatomic retropubic prostatectomy will achieve postoperative urinary continence.
2.Clinical study of combination therapy of tamsulosin and solifenacin for benign prostatic hyperplasia with overactive bladder
Chen JIANG ; Kai SUN ; Yonghui CHENG ; Wei XUE ; Yiran HUANG
Chinese Journal of Urology 2011;32(9):639-642
ObjectiveTo evaluate the efficacy and safety of combination therapy of tamsulosin and solifenacin for benign prostatic hyperplasia ( BPH ) with overactive bladder ( OAB ).Methods82 patients with OAB and coexisting BPH were randomly divided into tamsulosin group ( n = 38 ) and combination group ( n = 44). The ages were from 50 to 75 y ( averaged, 56.8 ± 8.6). Inclusion criteria: the mean frequency of micturition ≥8 times per day, the frequency of nocturia ≥2 times per day, voiding volume <200 ml each time; for the overactive bladder symptom score ( OA BSS), the 3 rd score > 2, total score > 3. The tamsulosin group accepted tamsulosin 0.2 mg once daily, the combination group accepted tansulouxin 0.2 mg and solifenacin 0.2 mg once daily. Both groups were maintained the corresponding therapy for 12 weeks.The international prostate symptom score (IPSS), Qmax, residual urine volume, OAB score and adverse reactions were recorded.ResultsThe values of IPSS ( 19.5 ±2.2 vs 15.6 ±2.4, P =0.027), the voiding symptom score ( 15.6 ± 2.4 vs 3.4 ± 1. 7, P = 0. 022) and Qmax ( 13.7 ± 3.8 vs 16.6 ± 4.1, P = 0. 034 )improved significantly after treatment in tamsulosin group ( P < 0. 05 ). The values of IPSS ( 19.7 ± 2.3 vs 9.7 ± 3.0, P <0. 001), the storage symptom score (13.8 ± 1.9 vs 5.6 ± 1.6, P <0. 001 ), OABSS (10.3 ±1.8 vs 5.3 ±1.3, P <0.001) and Qmax(14.1 ±4.1 vs 17.2 ±3.5, P=0.027) also improved significantly after treatment in combination group ( P < 0. 05 ). The values of IPSS ( 9.7 ± 3.0 vs 15.6 ±2.4, P < 0.001 ), the storage symptom score (5.6 ± 1.6 vs 12.0 ± 1.6, P < 0.001 ) and OABSS ( 5.3 ±1.3 vs 9.7 ± 2.7, P < 0. 001 ) improved significantly in combination group than those in tamsulosin group ( P <0.001 ). There were no difference between two groups in values of the voiding symptom score, Qmax and residual urine volume ( P > 0.05 ). The incidences of adverse reactions in tamsulosin group and combination group were 7.9% (3/38) and 20.5% (9/44) without significant difference. There was no acute urinary retention in both groups.ConclusionsIt is effective and safe for patients with BPH and OAB to accept combination therapy of tamsulosin and solifenacin.
3.Identification of nodules of altered hepatocytes from focal nodular hyperplasia,with comparison to hepatocellular adenoma
Yiran CAI ; Xiaoying TENG ; Guolian WEI ; Lei GUO ; Qin SU
Cancer Research and Clinic 2010;22(2):80-83,88
Objective Focal nodular hyperplasia(FNH) is composed of multiple hyperplastic liver cell nodules,but its pathogenesis has not been elucidated. Foci (FAH) or nodules of altered hepatocytes (NAH) are precursors of hepatocellular adenoma (HCA) and carcinoma.This study aimed at identifying FAH and NAH from FNH and evaluating their role in FNH development.Methods 6 FNH lesions from 5 patients and 10 HCA from 9 patients were examined histologically,and expression levels of CD_(34) cytokeratin 19(CKl9) and Ki-67 antigen were demonstrated immunohistochemicailly.Proliferative activity was evaluated by Ki-67 antigen-labeling indices(Ki-67 LI).Results Multiple FAH and NAH were identified in all of the 6 FNH lesions. Whiie micmvasculatures were demonstrated by CD_(34) immunoreactivity in both HCA and FNH,their density and distribution were different in these two lesions,being diffuse in HCA and focal or nodular,mainly within NAH.CKl9 expression Was found in FNH,localized in ductal and ductular cells,but not within NAH and HCA.Average Ki.67 LI of 73 NAH(2.8%) was shown to be higher than that of the whole FNH lesions (0.6%),and had no statistieal difference comparable to that of HCA(1.8%).Conclusion Muhiple NAH are present in all classical FNH lesions.Unlike the surrounding parenchyma,NAH lesions are more proliferative and equipped with CD_(34)-positive microvasculatures as in HCA.
4.Renal vein trauma in the echo-guide percutaneous nephrostomy(3 cases report)
Wei XUE ; Jiahua PAN ; Haige CHEN ; Yiran HUANG
Chinese Journal of Urology 2008;29(12):829-832
Objective To discuss the management of renal vein trauma in the percutaneous ne-phrostomy (PCN) procedure.Methods Three cases with renal vein trauma by PCN or malposition of nephrostomic catheter were reviewed.Case 1 was a patient with staghorn calculi.There was mas-sive hemorrhage after the puncture and the dilatation during PCN.Then the nephrostomy catheter was clamped.The post-operative CT scan showed the nephrostomy catheter passed the inferior vena cava to the right external jugular vein.Case 2 was a patient with a 3 cm calculus in the inferior calice of the right kidney.A massive haemorrage occurred after the dilatation by the 16 F sheath guided by ultra-sound during PCN.The nephrostomic catheter was found in the renal vein by X-ray film.Case 3 was a patient with bilateral hydronephrosis complicating chronic renal failure,which caused by the meta-static of the gastric carcinoma.After the puncture,the massive hemorrage appeared and a nephros-tomic catheter was placed and then clamped.The catheter was seen in the renal vein confirmed by the X-ray.For all 3 patients,the catheter was withdrawn carefully monitored by the X-ray until the place of the renal vein perforation during the first 24-48h.Then it was withdrawn 3 to 4 cm each time un-til reach the pelvic.Results The hemorrhage was well controlled and nobody needed the surgical in-tervention.There was no renal function aggravation in these 3 patients.Conclusions The renal vein trauma during the echo-guide PCN procedure can be treated by clamping the nephrostomy catheter and withdrawing it gradually.Thus,the surgical intervention can be avoided and this method will not im-pair the renal function.
5.Study on metabolic intensity value changes of points on the face using thermal chromatography technology
Le YU ; Zhongyu ZHOU ; Dan WEI ; Wei HUANG ; Yiran LIU ; Sanchun TAN
Journal of Acupuncture and Tuina Science 2015;(5):290-294
Objective:To observe the changes of metabolic intensity value of points on the face before and after needling bilateral Hegu (LI 4) in healthy people and provide scientific basis for association between Hegu (LI 4) and face/mouth. Methods:A total of 45 healthy college students were selected in this study. Using medical thermography and Pennes bio-heat transfer model, the infrared thermograph images on the face before and after needling bilateral Hegu (LI 4) were collected to observe the distribution of metabolic intensity value on the face before acupuncture and changes in these values after needling bilateral Hegu (LI 4). Results:Before acupuncture, Cuanzhu (BL 2) had the maximal metabolic intensity value. Its mean value was (0.71±0.23) W. Quanliao (SI 18) had the minimal metabolic intensity value. There were no left-right statistical significances in metabolic intensity values. After needling bilateral Hegu (LI 4), the metabolic intensity values of most points on the face were increased. Kouheliao (LI 19) obtained the maximal increase: 0.35 W on average; and Yangbai (GB 14) obtained the minimal increase: 0.08 W on average. Conclusion:Points on both sides in healthy people have good symmetry in metabolic intensity value. After needling bilateral Hegu (LI 4), the metabolic intensity values of points on the face were increased, especially points around the lips, which accords with the pathway of the Large Intestine Meridian on the head and face. This provided some scientific foundation for the association between Hegu (LI 4) and face/mouth.
6.Relationship of c-erbB2 overexpression with endocrine therapy and prognosis in patients with breast carcinoma
Peng GAO ; Gengyin ZHOU ; Junmin WEI ; Li LI ; Yiran CAI ; Miaoqing ZHAO ; Chengjun ZHOU
Chinese Journal of General Surgery 2001;0(10):-
Objective To investigate the relationship of c erbB2 with endocrine therapy and prognosis, to investigate the rapid and effective method to detect c erbB2 alteration in breast carcinoma(BC).Metheds Semi quantitative PCR was used to detect the amplification of c erbB2, and immunohistochemistry was used to detect the expression of protein of c erbB2. 58 cases of BC were followed up .Results There was significant relationship between c erbB2 protein overexpression and gene amplification(P
7.The factors and treatments of lower urinary tract injury caused by tension-free vaginal tape procedure
Jianwei Lü ; Jing LENG ; Wei XUE ; Lixin ZHOU ; Juanjie BO ; Dongming LIU ; Yiran HUANG
Chinese Journal of Urology 2012;33(7):522-524
Objective To discuss the influent factors and managements of lower urinary tract injury caused by tension-free vaginal tape (TVT) procedure. Methods From Mar.2001 to Feb.2011,609stress urinary incontinence (SUI) patients were trested by TVT.Lower urinary tract injury appeared in 39 cases (6.4%),which age from 39 to 78 years (average age 52.7 ± 18.3).The history of disease was 2 to 12 years.Preoperative SUI types were 12 cases of Ⅱ type SUI,22 cases of Ⅱ/Ⅲ type SUI and 5 cases of Ⅲ type SUI.The patients who had low urinary tract injury were retrospective analyzed to figure out the causes and influent factors,and recorded the treatments and follow-ups. Results 39 patients (6.4%) suffered from low urinary tract injury,including 36 oases (5.9%) of bladder perforation and 3 cases of urethral injury.In these 39 patients,34 (87.2%) patients had history of pelvic surgeries,including 18 (52.9%) cases of total hysterectomy,9 (26.5%) cases of cesarean section delivery,4 (11.8%) cases of hysteromyomectomia and 3 (8.8%) cases of ovarian surgery.All of the 36 bladder peeroration patients were re-punctured and the catheter was kept for 4 - 5 d.Three urethral injury patients were re-punctured after the urethral rupture was sutured and the catheter was kept for 2 weeks.All the 39 patients were cured and discharged.No urinary fistula,infection or other postoperative complications occurred. Conclusions The history of pelvic surgery may be an important risk factor of the lower urinary tract injury,which should pay attention.If the bladder perforation occurred,re-puncture should be taken by adjust the direction.If there was a urethral injury,the re-puncture should be taken after the suturing of the urethral rupture.
8.A study of a trial withdrawing of the urethral catheter in patients with acute urinary retention caused by benign prostatic hyperplasia under the treatment of alpha-adrenergic receptor blocker
Chen JIANG ; Yonghui CHEN ; Xiangfeng CHEN ; Zhendong LI ; Wei XUE ; Yiran HUANG
Chinese Journal of Geriatrics 2011;30(4):302-304
Objective To observe the influence of using alpha-adrenergic receptor blocker and catheterization time on the success rate of a trial without catheter (TWOC) in patients with acute urinary retention (AUR) caused by benign prostatic hyperplasia (BPH).Methods The 124patients from January 2007 to December 2009,aged 62-90 years (mean age 71.3 years),diagnosed as AUR caused by BPH in emergency room,were enrolled in this study.They were randomized to two groups:(1) Medication group:60 cases,who were given alpha-adrenergic receptor blocker 4 mg daily for 2-3 days before TWOC.Among them,there were 30 cases with catheterization for 3 days,and the rest 30 cases for 7 days;(2)Control group:64 cases,who were without alpha-adrenergic receptor blocker.Among them,there were 30 cases with catheterization for 3 days,and the rest 34 cases for 7days.The urine culture was made when the catheter was drawn out.Results (1)The success rate of TWOC was higher in medication group than in control group (71.7% vs.53.1%,x2 =4.523,P=0.033).Both in medication group and control group,the success rate was higher in patients with catheterization for7 days than for 3 days (83.3% vs.60.0%,x2=4.022,P=0.045;67.7% vs.36.7%,P=0.013).(2)After follow-up for 6 months,the patients with catheterization for 7 days had lower incidence rate of second AUR and selective operation (x2 =4.538 and 4.709,P=0.033 and 0.030).(3)There was no significant difference in rate of urinary infection between the patients with catheterization for 7 days and for 3 days (20.3% vs.16.7%,P = 0.603).Conclusions Alpha-adrenergic receptor blocker could increase the success rate of TWOC,and the success rate of TWOC is much higher in patients with catheterization for 7 days than for 3 days,while the urinary infection rate is not significantly increased.
9.Staged ureteroscopy in complicated cases
Jiahua PAN ; Wei XUE ; Haige CHEN ; Qi CHEN ; Yonghui CHEN ; Ming CAO ; Yiran HUANG
Chinese Journal of Urology 2011;32(6):396-398
Objective To discuss the feasibility and benefits of staged ureteroscopic laser lithotripsy in complicated cases. Methods From May 2005 to May 2008, the staged ureteroscopic procedure was done in 56 cases for ureteric stricture, kinking, spasm or high mobility of ureteric mucosa. Encountering difficulties, with the guide wire settled in place, the endoscopic procedure was ended and a ureteral stent was set. A second ureteroscopic procedure was carried out two weeks later. Results There was no difficulty for the insertion and the advancing of the ureteroscope two weeks later in all 56 cases. Among the 41 cases previously having the ureteric calculi, the stone was pushed into the kidney by the stent in 16 cases. There was no surgical complication during the second procedure. After three months the complete evacuation rate of the calculus was 96.4%. No patient experienced a fever >39.1 ℃ after the first attempt. Conclusions For complicated cases, such as ureteric stricture, spasm, kinking and high mobility of the ureteric mucosa which hinder the safe advancing of the ureteroscope, staged ureteroscopic procedure might be a safe and effective choice.
10.Ultra-mini percutaneous nephrolithotomy for the treatment of renal or upper ureteral stones (report of 32 cases)
Hanqing XUAN ; Qi CHEN ; Hai ZHONG ; Yang CAO ; Lei XIA ; Wei XUE ; Yiran HUANG
Chinese Journal of Urology 2016;37(6):427-430
Objective To investigate the efficacy and safety of ultra-mini percutaneous nephrolithotomy for the treatment of renal or upper ureteral stones.Methods The data of 32 patients diagnosed as renal or upper ureteral stones were retrospectively reviewed,who underwent ultra-mini percutaneous nephrolithotomy from June to October,2015,including 29 kidney stones,3 upper ureteral stones,of which 21 single stone,7 multiple stones,and 4 staghorn stones.There were 8 cases with inferior calyx stones,10 with renal pelvis stones,3 with upper ureteral stones,10 with renal pelvis stones plus inferior calyx stones and 1 with renal pelvis stones plus upper calyx stones.The mean stone size was (20.1 ±7.6) mm (ranging from 10 to 41mm).The mean Hounsfield unit (HU) was (1 125.9 ±225.9) Hu (ranging from 520 to 1 550Hu).In this cohort,13 cases had mild hydronephrosis,2 moderate hydronephrosis,1 severe hydronephrosis while no hydronephrosis identified in the other 16 patients.One case had concomitant kidney and ureter duplication malformation,and 1 case had residual stones after laparoscopic nephrolithotomy.Results All of the patients were treated by single tract UMP.Among them,middle calyceal puncture was performed in 9 cases,and the other 23 cases underwent lower calyceal puncture,including 4 cases of intercostal puncture,and 28 subcostal puncture.The mean operating time was (30.3 ± 15.0) min (ranging from 10 to 90 min).The mean postoperative hospital stay was (1.9 ± 1.0)days (ranging from 1 to 5 days).The mean hemoglobin decrease was(14.6 ±8.4)g/L (ranging from 1 to 46 g/L).No analgesics were used.Peri-operative complication rate was 3.13% (1/32) with 1 case of collection system perforation.There was no fever,severe bleeding,urinary extravasation,pleural injury,or blood transfusion.The SFR was 93.75% (30/32) and 96.88% (31/32) on the first day and the first month after the operation,respectively.Conclusions UMP could be a safe and effective method for the treatment of renal or upper ureteral stones,especially for inferior calyceal stones less than 2cm.It offers high stone clearance rate,minimally invasiveness,quick recovery,short length of hospital stay and improved quality of life.