1.A cohort study on the preventive effect of preserving the urethral ridge in transurethral Holmium laser enucleation of the prostate on retrograde ejaculation
Qinglong WU ; Songtao ZHAO ; Tao WANG ; Rongjin FANG ; Chao LI ; Jiqian WANG ; Yongchao WANG ; Yongmei CHEN ; Weiwen LIU ; Bin CHEN
Chinese Journal of Urology 2025;46(9):676-683
Objective:To investigate the efficacy of preserving the urethral ridge during Holmium laser enucleation of the prostate(HoLEP)in preventing postoperative retrograde ejaculation and to evaluate its impact on sexual function.Methods:This prospective cohort study enrolled patients with benign prostatic hyperplasia(BPH)who underwent HoLEP at Xiamen Haicang Hospital(Haicang Hospital Affiliated to Xiamen Medical College)from November 2022 to June 2024. Inclusion criteria were as follows:diagnosis of BPH confirmed by color Doppler ultrasound;International Prostate Symptom Score(IPSS)> 7;maximum urinary flow rate(Q max)< 15 ml/s;prostate-specific antigen(PSA)< 4 ng/ml;and an active sexual life with intact antegrade ejaculation. Exclusion criteria included neurogenic bladder,active urinary tract infection(UTI),and other relevant conditions. Patients were grouped based on the operating surgeon's comprehensive judgment during surgery,considering the degree of prostatic median lobe hyperplasia(preserved if hyperplasia was mild,not preserved if severe). The EP-HoLEP group underwent “tunnel technique” enucleation of the middle lobe hyperplasia with preservation of the urethral ridge,while the HoLEP group underwent conventional prostate enucleation. Primary outcomes included postoperative retrograde ejaculation rate,International Index of Erectile Function(IIEF),Ejaculation Projection Score(EPS),IPSS,Quality of Life Score(QOL),Q max,post-void residual urine volume(PVR),operative time,and postoperative complications. Univariate analysis was used to screen potential influencing factors,followed by multivariate logistic regression to identify independent predictors. Results:Seventy patients with BPH were enrolled,with 35 in each group. Baseline characteristics,including age[(69.97 ± 5.14)years vs.(72.34 ± 5.08)years],body mass index(BMI)[(22.99 ± 1.41)kg/m2 vs.(23.16 ± 1.38)kg/m2],prostate volume[47.4(31.9,59.4)ml vs. 44.2(34.9,61.7)ml],PSA[4.0(1.9,8.2)ng/ml vs. 3.1(2.6,5.0)ng/ml],hemoglobin[(130.09 ± 12.92)g/L vs.(125.69 ± 17.26)g/L],IPSS[17(10,22)vs. 17(10,27)],QOL[5(4,5)vs. 4(4,5)],Q max[7.5(6.3,9.1)ml/s vs. 7.0(5.9,8.9)ml/s]and PVR[65(22,167)ml vs. 60(16,150)ml]showed no statistically significant differences between the two groups( P > 0.05). Operative time[65(55,76)min vs. 63(55,73)min],postoperative 2-hour hemoglobin[(124.17 ± 14.89)g/L vs.(120.11 ± 15.44)g/L],and postoperative hospital stay[(3.94 ± 1.89)days vs.(3.66 ± 1.53)days]were also comparable between the two groups( P > 0.05). No significant difference was observed in the decrease in IIEF score[1(0,2)vs. 2(0,6), P = 0.203]. EPS at 3 months[2(1,3)vs. 1(0,2), P < 0.001]and at 6 months[2(1,2)vs. 1(0,2), P < 0.001]postoperatively were significantly higher in the EP-HoLEP group. The incidence of postoperative UTI did not differ significantly[5.7%(2/35)vs. 2.9%(1/35), P = 1.00]. Two cases of urinary retention occurred after catheter removal in the EP-HoLEP group,while none occurred in the HoLEP group. No blood transfusions or urethral strictures were reported in either group. The incidence of retrograde ejaculation was significantly lower in the EP-HoLEP group[28.6%(10/35)vs. 68.6%(24/35), P <0.001]. Multivariable logistic regression analysis showed that urethral ridge preservation was an independent protective factor for retrograde ejaculation after HoLEP( OR = 0.159,95% CI 0.053 ? 0.476, P = 0.001). Conclusions:Urethral ridge preservation during HoLEP is safe and feasible,significantly reduces retrograde ejaculation,and preserves ejaculatory function,though it offers limited erectile function preservation. This approach is suitable for middle-aged,young,or younger elderly patients who prioritize ejaculatory quality,and provides clinical evidence for surgical optimization.
2.A cohort study on the preventive effect of preserving the urethral ridge in transurethral Holmium laser enucleation of the prostate on retrograde ejaculation
Qinglong WU ; Songtao ZHAO ; Tao WANG ; Rongjin FANG ; Chao LI ; Jiqian WANG ; Yongchao WANG ; Yongmei CHEN ; Weiwen LIU ; Bin CHEN
Chinese Journal of Urology 2025;46(9):676-683
Objective:To investigate the efficacy of preserving the urethral ridge during Holmium laser enucleation of the prostate(HoLEP)in preventing postoperative retrograde ejaculation and to evaluate its impact on sexual function.Methods:This prospective cohort study enrolled patients with benign prostatic hyperplasia(BPH)who underwent HoLEP at Xiamen Haicang Hospital(Haicang Hospital Affiliated to Xiamen Medical College)from November 2022 to June 2024. Inclusion criteria were as follows:diagnosis of BPH confirmed by color Doppler ultrasound;International Prostate Symptom Score(IPSS)> 7;maximum urinary flow rate(Q max)< 15 ml/s;prostate-specific antigen(PSA)< 4 ng/ml;and an active sexual life with intact antegrade ejaculation. Exclusion criteria included neurogenic bladder,active urinary tract infection(UTI),and other relevant conditions. Patients were grouped based on the operating surgeon's comprehensive judgment during surgery,considering the degree of prostatic median lobe hyperplasia(preserved if hyperplasia was mild,not preserved if severe). The EP-HoLEP group underwent “tunnel technique” enucleation of the middle lobe hyperplasia with preservation of the urethral ridge,while the HoLEP group underwent conventional prostate enucleation. Primary outcomes included postoperative retrograde ejaculation rate,International Index of Erectile Function(IIEF),Ejaculation Projection Score(EPS),IPSS,Quality of Life Score(QOL),Q max,post-void residual urine volume(PVR),operative time,and postoperative complications. Univariate analysis was used to screen potential influencing factors,followed by multivariate logistic regression to identify independent predictors. Results:Seventy patients with BPH were enrolled,with 35 in each group. Baseline characteristics,including age[(69.97 ± 5.14)years vs.(72.34 ± 5.08)years],body mass index(BMI)[(22.99 ± 1.41)kg/m2 vs.(23.16 ± 1.38)kg/m2],prostate volume[47.4(31.9,59.4)ml vs. 44.2(34.9,61.7)ml],PSA[4.0(1.9,8.2)ng/ml vs. 3.1(2.6,5.0)ng/ml],hemoglobin[(130.09 ± 12.92)g/L vs.(125.69 ± 17.26)g/L],IPSS[17(10,22)vs. 17(10,27)],QOL[5(4,5)vs. 4(4,5)],Q max[7.5(6.3,9.1)ml/s vs. 7.0(5.9,8.9)ml/s]and PVR[65(22,167)ml vs. 60(16,150)ml]showed no statistically significant differences between the two groups( P > 0.05). Operative time[65(55,76)min vs. 63(55,73)min],postoperative 2-hour hemoglobin[(124.17 ± 14.89)g/L vs.(120.11 ± 15.44)g/L],and postoperative hospital stay[(3.94 ± 1.89)days vs.(3.66 ± 1.53)days]were also comparable between the two groups( P > 0.05). No significant difference was observed in the decrease in IIEF score[1(0,2)vs. 2(0,6), P = 0.203]. EPS at 3 months[2(1,3)vs. 1(0,2), P < 0.001]and at 6 months[2(1,2)vs. 1(0,2), P < 0.001]postoperatively were significantly higher in the EP-HoLEP group. The incidence of postoperative UTI did not differ significantly[5.7%(2/35)vs. 2.9%(1/35), P = 1.00]. Two cases of urinary retention occurred after catheter removal in the EP-HoLEP group,while none occurred in the HoLEP group. No blood transfusions or urethral strictures were reported in either group. The incidence of retrograde ejaculation was significantly lower in the EP-HoLEP group[28.6%(10/35)vs. 68.6%(24/35), P <0.001]. Multivariable logistic regression analysis showed that urethral ridge preservation was an independent protective factor for retrograde ejaculation after HoLEP( OR = 0.159,95% CI 0.053 ? 0.476, P = 0.001). Conclusions:Urethral ridge preservation during HoLEP is safe and feasible,significantly reduces retrograde ejaculation,and preserves ejaculatory function,though it offers limited erectile function preservation. This approach is suitable for middle-aged,young,or younger elderly patients who prioritize ejaculatory quality,and provides clinical evidence for surgical optimization.
3.Pathogenic surveillance of viral diarrhea in Minhang District of Shanghai in 2014-2020
Lingfei LUO ; Xiaoguang WANG ; Hongjing YAN ; Shanshan ZHEN ; Zhihan WANG ; Beier FU ; Jiqian LIU
Journal of Public Health and Preventive Medicine 2022;33(3):76-80
Objective To investigate the epidemiological and pathogenic characteristics of viral diarrhea in Minhang District, Shanghai. Methods Random sampling on diarrhea was conducted in intestinal outpatient departments of 2 sentinel hospitals according to a certain sampling interval in Minhang District,Shanghai from 2014 to 2020. Real time PCR technology was used to detect Rotavirus, Norovirus, adenovirus, Astrovirus and Sapovirus in fecal samples. Results A total of 646 out of 1 839 stool specimenswere tested positive, and the positive rate was 35.13%.Five pathogenic viruses were detected , mostly norovirus (421 cases, 65.17%) followed by rotavirus (151 cases, 23.37%).The positive rate of norovirus was higher in the age group of 20- 69 years, and the positive rate of Rotavirus was higher in the age group of 0- 9 years. Conclusions Norovirus and rotavirus accounted for the majority of reported infection diarrhea cases in MinhangDistrict of Shanghai from 2014 to 2020, with significant seasonal peaks. Tailored prevention and control measures should be carried out, particularly in risk seasons.
4.Development of an LB cloning system and its application in expression of fusion genes in Sphingomonas sp. WG.
Han XUE ; Hui LI ; Mengqi CHEN ; Zaimei ZHANG ; Zhongrui GUO ; Hu ZHU ; Jiqian WANG ; Yawei SUN
Chinese Journal of Biotechnology 2022;38(4):1576-1588
In order to overcome the challenges of insufficient restriction enzyme sites, and construct a fusion-expression vector with flexible fusion direction, we designed an LB cloning system based on the type IIS and type IIT restriction enzymes LguⅠ and BbvCⅠ. The LB cloning system is constructed by inserting the LB fragment (GCTCTTCCTCAGC) into the multiple cloning site region of the broad-host plasmid pBBR1MCS-3 using PCR. The LB fragment contains partially overlapped recognition sites of LguⅠ and BbvCⅠ. Therefore, the same non-palindromic sequence will be generated by these two restriction endonucleases digestion. This feature can be used to quickly and flexibly insert multiple genes into the expression vector in a stepwise and directed way. In order to verify the efficacy of the cloning system, two glycosyltransferase genes welB and welK of Sphingomonas sp. WG were consecutively fused to the LB cloning vector, and the recombinant plasmid was transferred into Sphingomonas sp. WG by triparental mating. The results showed that gene fusion expression has little effect on sphingan titer, but enhanced the viscosity of sphingan. The viscosity of the sphingan produced by recombinant strain Sphingomonas sp. WG/pBBR1MCS-3-LB-welKB was 24.7% higher than that of the wild strain after fermentation for 84 h, which would be beneficial for its application. In conclusion, the application of LB cloning system were verified using Sphingomonas sp. WG. The LB cloning system may provide an efficient tool for fusion expression of target genes.
Base Sequence
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Cloning, Molecular
;
Fermentation
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Plasmids/genetics*
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Sphingomonas/metabolism*
5.Protective effect of metoprolol on ischemia-reperfusion induced myocardial tissue injury in mice
Haiyan CHEN ; Houxiang HU ; Jiqian XU ; Lei XU ; Shuang ZHANG ; Huan WANG ; Rongyi ZHANG ; Rongchuan YUE ; Tao LUO
Chongqing Medicine 2016;(3):317-319
Objective To investigate the possible mechanism of metoprolol on protecting against ischemia‐reperfusion in‐duced injury .Methods A total of 32 healthy 3-4 months male C57BL/6 mice were divided into four groups(n=8)as following :Sham‐operating group(control group);metoprolol group;ischemia‐reperfusion group(I/R group);metoprolol + I/R group .Myo‐cardial injury ,apoptosis ,cytochrome c release ,Caspase‐3 activity and calpain activity were determined in these groups .Results Al‐though there was no obvious changes in the regions at risk between I/R group and metoprolol + I/R group ,metoprolol pretreat‐ment significantly reduced the ratio of the infarct to risk regions(P<0 .05) .In the I/R group ,the rate of cardiomyocyte apoptosis , cytochrome c release ,as well as the activity of Caspase‐3 and calpain significantly increased compared to the control group(P<0 .01) .However ,these effects of I/R injury were alleviated by pretreatment with metoprolol .Conclusion metoprolol might protect against ischemia‐reperfusion induced injury by preventing calpain activation .
6.Experimental study on liver microcirculation disturbance following transplantation and the protective effect of prostaglandin E1 in the rat
Hao LIU ; Liming WANG ; Yongfeng LIU ; Jindan SONG ; Jiqian HUANG ; Sanguang HE
Chinese Medical Journal 1998;(12):1079-1082
Objective To determine the effect of PGE1 on liver microcirculation disturbance following orthotopic liver transplantation in rats.Methods Forty male adult Wistar rats were divided randomly into 3 groups. Eight transplantations were established in both the experimental and control group, while in the sham group, the liver was dissected like in the experimental group, but no resection was performed. In the experimental group, PGE1 (0.5 μg/kg*min-1) was injected intravenously into the donor before the operation, and added (1 mg/L)to the flush and preservation fluid, while PGE1 was replaced by normal saline in the control group. Confocal laser scan microscopy, biochemical test, and optical and electronic microscopy were used.Results In the control group the reperfusion state was poor,leukocyte infiltration appeared in the center of lobule,and transaminase rose after transplantation. In the experimental group distinctive improvement was seen as compared with the control group (P<0.05). Histological findings showed progressive degeneration and necrosis following transplantation in the control group, while in the experimental group the histological changes were improved to some degree by the use of PGE1.Conclusions In liver transplantation, ischemic reperfusion damage may lead to hepatic microcirculation disturbance, which is the major cause of graft failure. Infusing PGE1 into the donor intravenously before ischemia and adding PGE1 to the cold storage fluid could improve hepatic microcirculation, and thus reducing ischemic reperfusion damage in liver transplantation.In liver transplantation, ischemic reperfusion damage may lead to hepatic microcirculation disturbance, which is the major cause of graft failure. Infusing PGE1 into the donor intravenously before ischemia and adding PGE1 to the cold storage fluid could improve hepatic microcirculation, and thus reducing ischemic reperfusion damage in liver transplantation.


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