1.Real-world patient satisfaction with hyaluronic acid filler HYC-24/HYC-24+ for the treatment of moderate to severe nasolabial folds in China
Ling CAO ; Weimin SONG ; Shiliang XU ; Zhifu SUI ; Maglambayan JOY ; Patel VAISHALI
Chinese Journal of Plastic Surgery 2024;40(4):436-443
Objective:To assess the real-world patient satisfaction with the outcomes in Chinese patients who received HYC-24/HYC-24+ for the treatment of moderate to severe nasolabial folds (NLF).Methods:This study was a prospective, observational, multicenter, real-world cohort study in which patients accepted treatment with HYC-24/HYC-24+ in China during a period from August 2018 to August 2020 at Beijing Lidu Medical Beauty Hospital, Hangzhou Yanshu Yuerong Medical Aesthetic Clinic, and Guangzhou Yuexiu Plastic Surgery Hospital and were followed up for up to 1 year. Patients were adults aged 18 to 65 years with moderate to severe NLF who had not received cosmetic treatment for NLF within 6 months prior to study enrollment. Post-treatment study visits were conducted at Months 1, 6, 9, and 12, but only Months 6 and 9 were required visits. The primary patient-reported outcomes endpoints included the FACE-Q satisfaction with outcome total score (a score from 0 to 100: a higher score indicates better outcomes and higher patient satisfaction), FACE-Q appraisal of lines - NLFs total questionnaire score mean change from baseline (a score from 0 to 100: a higher score indicates the patient was less troubled by NLF in the past week), and proportion of patients who reported that they looked younger than the actual age on the FACE-Q patient perceived age visual analog scale (VAS). Investigator-assessed endpoints included the proportion of patients with a global aesthetic improvement scale (GAIS) score of ≥ 1 point and the proportion of patients with an improvement in NLF severity of ≥ 1 point using the nasolabial fold severity scale (NLFSS). Statistical analyses were performed with SAS software, version 9.4. Measurement data were expressed as Mean±SD, and count data were expressed using cases(%). For both measurement and count data, P values were calculated on the difference between score values at different time points versus baseline using the Wilcoxon signed rank test. Results:A total of 52 subjects were enrolled and treated. Among these subjects, 7 were not included in the 6-month effectiveness analysis data set because the visit time exceeded the visit assessment window, and only 9 patients completed the 12-month visit. All patients were Chinese women, aged 26 to 62 years old, with a mean age of 40.7 years. The FACE-Q satisfaction with outcome total score was (68.76 ± 21.03) points (38-100) at Month 6, and (65.44±18.24) points (24-100) at Month 9, indicating high patient satisfaction with the treatment. The FACE-Q appraisal of lines-NLFs total score was (42.4±15.1) points (10-69) at baseline, (76.9±20.6) points (36-100) at Month 6, and (74.2±16.7) points (36-100) at Month 9, both significantly higher than the baseline scores (both P<0.01). The mean change from baseline in the FACE-Q appraisal of lines-NLFs total scores at Month 6 and Month 9 were 34.9 and 31.8 points, respectively, indicating the disturbance caused by NLF was relatively mild after treatment. The proportion of patients who believed they looked younger than their actual age on the FACE-Q patient perceived age VAS increased from 28.9% (15/52) at baseline to 77.8% (35/45) at Month 6, and 73.1% (38/52 ) at Month 9. The differences were all statistically significant compared to baseline ( P <0.01). At each post-baseline visit, all patients had ≥ 1-point improvement on the GAIS scale, indicating an improvement in patient NLF appearance in the investigators’ opinion. In terms of the NLFSS assessment, 97.8% (44/45) and 82.7% (43/52) of patients achieved a ≥ 1-point improvement on the NLFSS at Months 6 and 9, respectively. No adverse events were reported during the study. Conclusion:In a real-world setting, after the administration of HYC-24/HYC-24+ to Chinese patients, the patients were satisfied with the outcomes based on validated questionnaires. The patients also reported looking younger than their actual age and being less disturbed by NLF. Clinician-reported outcomes were consistent with patient-reported outcomes, indicating improvement in NLF.
2.Effect of complement C1s on biological behavior of esophageal squamous cell carcinoma
Ling REN ; Yuling CHEN ; Fengmin XU ; Chunmei MENG ; Qianqian LI ; Weimin HU
Chinese Journal of Immunology 2024;40(1):127-133
Objective:To explore the effect of complement component C1s on the proliferation,migration and adhesion of esophageal squamous cell carcinoma(ESCC)cells and on the growth of xenograft tumors in nude mice.Methods:The C1S mRNA ex-pression of ESCC tissues and adjacent normal tissues(ANTs)were analyzed using NCBI-GEO database.The C1s expression of ESCC cell lines was analyzed with RT-qPCR and Western blot.The knockdown or overexpression of C1s in ESCC cells lines was performed using C1s small interfering RNA(siRNA),C1s short hairpin RNA(shRNA)or C1s overexpression lentivirus,and the cell prolifera-tion was detected by CCK-8 assay,cell migration was detected by cell wound healing assay,cell adhesion was detected by cell-matrix adhesion assay,the expressions of matrix metalloproteinases MMP1 and MMP13 were detected by Western blot,and the effect of C1s on the growth of xenograft tumors in nude mice was detected by subcutaneous tumorigenesis assay in nude mice.The expression of CD34 in the xenograft tumors was detected by immunohistochemistry,and the formation of tumor microvessel was analyzed.Results:The expression of C1S mRNA in ESCC tissues was significantly higher than that in ANTs.Knockdown of C1s significantly suppressed proliferation,migration and cell-matrix adhesion of ESCC cells,as well as growth of xenograft tumors in nude mice,while overexpres-sion of C1s had the opposite effects.The expressions of MMP1 and MMP13 were decreased in ESCC cells TE-1 with C1s knockdown.Compared with control group,the microvessel of the xenograft tumors in the C1s overexpression group were more abundant.Conclu-sion:C1s is significantly upregulated in ESCC tissues,and promotes proliferation,migration,cell-matrix adhesion of ESCC cells,and the growth of xenograft tumors.C1s may play an important role in the occurrence and development of ESCC.
3.Real-world patient satisfaction with hyaluronic acid filler HYC-24/HYC-24+ for the treatment of moderate to severe nasolabial folds in China
Ling CAO ; Weimin SONG ; Shiliang XU ; Zhifu SUI ; Maglambayan JOY ; Patel VAISHALI
Chinese Journal of Plastic Surgery 2024;40(4):436-443
Objective:To assess the real-world patient satisfaction with the outcomes in Chinese patients who received HYC-24/HYC-24+ for the treatment of moderate to severe nasolabial folds (NLF).Methods:This study was a prospective, observational, multicenter, real-world cohort study in which patients accepted treatment with HYC-24/HYC-24+ in China during a period from August 2018 to August 2020 at Beijing Lidu Medical Beauty Hospital, Hangzhou Yanshu Yuerong Medical Aesthetic Clinic, and Guangzhou Yuexiu Plastic Surgery Hospital and were followed up for up to 1 year. Patients were adults aged 18 to 65 years with moderate to severe NLF who had not received cosmetic treatment for NLF within 6 months prior to study enrollment. Post-treatment study visits were conducted at Months 1, 6, 9, and 12, but only Months 6 and 9 were required visits. The primary patient-reported outcomes endpoints included the FACE-Q satisfaction with outcome total score (a score from 0 to 100: a higher score indicates better outcomes and higher patient satisfaction), FACE-Q appraisal of lines - NLFs total questionnaire score mean change from baseline (a score from 0 to 100: a higher score indicates the patient was less troubled by NLF in the past week), and proportion of patients who reported that they looked younger than the actual age on the FACE-Q patient perceived age visual analog scale (VAS). Investigator-assessed endpoints included the proportion of patients with a global aesthetic improvement scale (GAIS) score of ≥ 1 point and the proportion of patients with an improvement in NLF severity of ≥ 1 point using the nasolabial fold severity scale (NLFSS). Statistical analyses were performed with SAS software, version 9.4. Measurement data were expressed as Mean±SD, and count data were expressed using cases(%). For both measurement and count data, P values were calculated on the difference between score values at different time points versus baseline using the Wilcoxon signed rank test. Results:A total of 52 subjects were enrolled and treated. Among these subjects, 7 were not included in the 6-month effectiveness analysis data set because the visit time exceeded the visit assessment window, and only 9 patients completed the 12-month visit. All patients were Chinese women, aged 26 to 62 years old, with a mean age of 40.7 years. The FACE-Q satisfaction with outcome total score was (68.76 ± 21.03) points (38-100) at Month 6, and (65.44±18.24) points (24-100) at Month 9, indicating high patient satisfaction with the treatment. The FACE-Q appraisal of lines-NLFs total score was (42.4±15.1) points (10-69) at baseline, (76.9±20.6) points (36-100) at Month 6, and (74.2±16.7) points (36-100) at Month 9, both significantly higher than the baseline scores (both P<0.01). The mean change from baseline in the FACE-Q appraisal of lines-NLFs total scores at Month 6 and Month 9 were 34.9 and 31.8 points, respectively, indicating the disturbance caused by NLF was relatively mild after treatment. The proportion of patients who believed they looked younger than their actual age on the FACE-Q patient perceived age VAS increased from 28.9% (15/52) at baseline to 77.8% (35/45) at Month 6, and 73.1% (38/52 ) at Month 9. The differences were all statistically significant compared to baseline ( P <0.01). At each post-baseline visit, all patients had ≥ 1-point improvement on the GAIS scale, indicating an improvement in patient NLF appearance in the investigators’ opinion. In terms of the NLFSS assessment, 97.8% (44/45) and 82.7% (43/52) of patients achieved a ≥ 1-point improvement on the NLFSS at Months 6 and 9, respectively. No adverse events were reported during the study. Conclusion:In a real-world setting, after the administration of HYC-24/HYC-24+ to Chinese patients, the patients were satisfied with the outcomes based on validated questionnaires. The patients also reported looking younger than their actual age and being less disturbed by NLF. Clinician-reported outcomes were consistent with patient-reported outcomes, indicating improvement in NLF.
4.PXR activation impairs hepatic glucose metabolism partly via inhibiting the HNF4α-GLUT2 pathway.
Peihua LIU ; Ling JIANG ; Weimin KONG ; Qiushi XIE ; Ping LI ; Xiaonan LIU ; Jiayi ZHANG ; Ming LIU ; Zhongjian WANG ; Liang ZHU ; Hanyu YANG ; Ying ZHOU ; Jianjun ZOU ; Xiaodong LIU ; Li LIU
Acta Pharmaceutica Sinica B 2022;12(5):2391-2405
Drug-induced hyperglycemia/diabetes is a global issue. Some drugs induce hyperglycemia by activating the pregnane X receptor (PXR), but the mechanism is unclear. Here, we report that PXR activation induces hyperglycemia by impairing hepatic glucose metabolism due to inhibition of the hepatocyte nuclear factor 4-alpha (HNF4α)‒glucose transporter 2 (GLUT2) pathway. The PXR agonists atorvastatin and rifampicin significantly downregulated GLUT2 and HNF4α expression, and impaired glucose uptake and utilization in HepG2 cells. Overexpression of PXR downregulated GLUT2 and HNF4α expression, while silencing PXR upregulated HNF4α and GLUT2 expression. Silencing HNF4α decreased GLUT2 expression, while overexpressing HNF4α increased GLUT2 expression and glucose uptake. Silencing PXR or overexpressing HNF4α reversed the atorvastatin-induced decrease in GLUT2 expression and glucose uptake. In human primary hepatocytes, atorvastatin downregulated GLUT2 and HNF4α mRNA expression, which could be attenuated by silencing PXR. Silencing HNF4α downregulated GLUT2 mRNA expression. These findings were reproduced with mouse primary hepatocytes. Hnf4α plasmid increased Slc2a2 promoter activity. Hnf4α silencing or pregnenolone-16α-carbonitrile (PCN) suppressed the Slc2a2 promoter activity by decreasing HNF4α recruitment to the Slc2a2 promoter. Liver-specific Hnf4α deletion and PCN impaired glucose tolerance and hepatic glucose uptake, and decreased the expression of hepatic HNF4α and GLUT2. In conclusion, PXR activation impaired hepatic glucose metabolism partly by inhibiting the HNF4α‒GLUT2 pathway. These results highlight the molecular mechanisms by which PXR activators induce hyperglycemia/diabetes.
5.The abnormalities of free uroflow curve in female patients with detrusor underactivity and their clinical significance
Libo LIU ; Lina LI ; Shengfei XU ; Jiang CHEN ; Dan CAI ; Qing LING ; Zongbiao ZHANG ; Peng CAO ; Lei XU ; Xiaoyu WU ; Xiaoyi YUAN ; Weimin YANG ; Yuan CHEN ; Guanghui DU
Chinese Journal of Urology 2022;43(1):56-61
Objective:To explore the features of free uroflow(FF) curve patterns in female patients with detrusor underactivity(DU) and their clinical significance.Methods:Data of 275 adult female patients with lower urinary tract symptoms(LUTS) underwent urodynamic studies(UDS) at urology center of our hospital from June 2014 to June 2016 were analyzed retrospectively. The uroflow curve patterns of patients with DU were classified and analyzed in the context of parameters of FF, cystometry (CM), and pressure-flow study(PFS). The prevalence of each abnormal uroflow curve pattern in DU patients were calculated and compared with those in non-DU patients.Results:No bell-shaped curve was found in 141 patients with DU. The abnormal curve patterns can be divided into 5 types: Type Ⅰ (bell-shaped curve with saw tooth) in 20 cases (14.2%), Type Ⅱ (box-like curve) in 34 cases (24.1%), Type Ⅲ (triangle curve with decreasing slop) in 62 cases(43.9%), Type Ⅳ (triangle curve with increasing slop) in 4 cases (4.3%), Type Ⅴ (tide-wave curve)in 19 cases (13.5%). Maximum flow rate of free uroflow(Q max.FF) of type Ⅰ [(28.4±9.7) ml/s] was significantly greater than that of type Ⅱ, Ⅲ and Ⅴ[(17.0±4.1), (15.8±5.4) and (12.9±6.4) ml/s, P<0.05]. Flow time of free uroflow(FT.FF) of type Ⅲ and Ⅴ [(43.7±17.2) and (50.1±28.9)s] were significantly longer than that of type Ⅰ and Ⅱ [(18.5±7.3)s and (27.2±9.7)s, P<0.05]. Post voided residual > 50ml was noted in 19 cases (30.6%) of type Ⅲ, 7 cases (36.8%) of type Ⅴ, 1 case (2.9%) of type Ⅱ and no one in type Ⅰ and Ⅳ. Abnormal manifestations in cystometry mainly included bladder hypersensitivity, detrusor overactivity, and stress urinary incontinence. Detrusor pressure at Q max (Pdet.Q max) of type Ⅴ [(7.4±5.0) cmH 2O] was significantly lower than that of type Ⅰ, Ⅱ, Ⅲ [(11.8±6.7), (12.0±5.3), (12.1±5.0) cmH 2O, P<0.05]. Among 134 cases of non-DU, there were type Ⅰ curves in 88 cases (65.7%), type Ⅱ curves in 4 cases (2.9%), type Ⅲ curves in 15 cases (11.2%), type Ⅳ curves in 1 cases (0.7%), type Ⅴ curves in 7 cases (5.2%). And normal bell-shaped curves in 19 cases(14.2%). The prevalence of type Ⅱ, Ⅲ and Ⅴ in DU patients was significantly higher than that in the non DU patients ( P<0.05). Conclusions:This study reveals that the characteristics of reduced detrusor contractility and duration, prolonged bladder emptying or incomplete emptying can be reflected in the patterns of free uroflow curve in female patients with DU. The abnormalities of these free uroflow curve patterns, especially type Ⅱ, Ⅲ and Ⅴ will be helpful in preliminarily screening DU in females.
6.Analysis of the clinical effects and outcome of patients with double-hit high-risk multiple myeloma
Shan LIU ; Jin SHANG ; Yun LIN ; Zhihong WANG ; Tiannan WEI ; Ling LIN ; Tong YANG ; Weimin CHEN
Chinese Journal of Oncology 2021;43(11):1209-1214
Objective:To compare the clinical features, clinical efficacy, and prognosis of patients with double-hit and non-double-hit high-risk multiple myeloma (MM) and explored the clinical significance of high-risk cell karyotype in MM development.Methods:The clinical data of 73 high-risk MM patients admitted to the Department of Hematology of Fujian Provincial Hospital from January 2011 to February 2019 were retrospectively analyzed. Interphase fluorescence in situ hybridization was used to detect their karyotypes. Based on mSMART 3.0 risk stratification, we divided the patients into a double-hit group (28 cases) and a non-double-hit group (45 cases).Results:Fifteen patients in the double-hit group and 26 in the non-double-hit group received bortezomib-based chemotherapy. The median progression-free survival (PFS) in the double-hit and the non-double-hit groups was 8.0 months and 22.0 months, and the median overall survival (OS) was 10.0 months and not reached, respectively. Ten patients in the double-hit group and 12 in the non-double-hit group received bortezomib combined with lenalidomide (RVD) chemotherapy. The median PFS in the double-hit group and the non-double-hit group was 12.0 months and 24.0 months, and the median OS was 14.0 months and not reached, correspondingly. Both the PFS and OS of the double-hit group were significantly shorter than those of the non-double-hit group ( P<0.05). Univariate analysis results indicated that cytogenetic abnormalities, revised-international staging system (R-ISS), β2 microglobulin, and calcium had significant effects on PFS in high-risk MM patients ( P<0.05). The cytogenetic abnormalities, R-ISS, and β2 microglobulin were associated with OS in high-risk MM patients ( P=0.001). Multivariate Cox regression analysis showed that the cytogenetic grouping was an independent prognostic factor for OS and PFS in high-risk MM patients. The risk of disease progression was 3.160 times (95% CI: 1.364-7.318) and the risk of death was 2.966 times higher (95% CI: 1.205-7.306) in the double-hit group than those in the non-double-hit group. Calcium was an independent risk factor for PFS in the high-risk MM patients. Notably, the risk of disease progression in patients with calcium levels≥ 2.75 mmol/L was 2.667 times higher than that in patients with calcium<2.75 mmol/L (95% CI: 1.209-5.883). Conclusions:Double-hit patients are a highly specific group with worse high-risk MM prognosis. In such patients, the relapse is more common, the disease progression is faster, and the survival time is shorter than those in the non-double-hit patients.
7.Analysis of the clinical effects and outcome of patients with double-hit high-risk multiple myeloma
Shan LIU ; Jin SHANG ; Yun LIN ; Zhihong WANG ; Tiannan WEI ; Ling LIN ; Tong YANG ; Weimin CHEN
Chinese Journal of Oncology 2021;43(11):1209-1214
Objective:To compare the clinical features, clinical efficacy, and prognosis of patients with double-hit and non-double-hit high-risk multiple myeloma (MM) and explored the clinical significance of high-risk cell karyotype in MM development.Methods:The clinical data of 73 high-risk MM patients admitted to the Department of Hematology of Fujian Provincial Hospital from January 2011 to February 2019 were retrospectively analyzed. Interphase fluorescence in situ hybridization was used to detect their karyotypes. Based on mSMART 3.0 risk stratification, we divided the patients into a double-hit group (28 cases) and a non-double-hit group (45 cases).Results:Fifteen patients in the double-hit group and 26 in the non-double-hit group received bortezomib-based chemotherapy. The median progression-free survival (PFS) in the double-hit and the non-double-hit groups was 8.0 months and 22.0 months, and the median overall survival (OS) was 10.0 months and not reached, respectively. Ten patients in the double-hit group and 12 in the non-double-hit group received bortezomib combined with lenalidomide (RVD) chemotherapy. The median PFS in the double-hit group and the non-double-hit group was 12.0 months and 24.0 months, and the median OS was 14.0 months and not reached, correspondingly. Both the PFS and OS of the double-hit group were significantly shorter than those of the non-double-hit group ( P<0.05). Univariate analysis results indicated that cytogenetic abnormalities, revised-international staging system (R-ISS), β2 microglobulin, and calcium had significant effects on PFS in high-risk MM patients ( P<0.05). The cytogenetic abnormalities, R-ISS, and β2 microglobulin were associated with OS in high-risk MM patients ( P=0.001). Multivariate Cox regression analysis showed that the cytogenetic grouping was an independent prognostic factor for OS and PFS in high-risk MM patients. The risk of disease progression was 3.160 times (95% CI: 1.364-7.318) and the risk of death was 2.966 times higher (95% CI: 1.205-7.306) in the double-hit group than those in the non-double-hit group. Calcium was an independent risk factor for PFS in the high-risk MM patients. Notably, the risk of disease progression in patients with calcium levels≥ 2.75 mmol/L was 2.667 times higher than that in patients with calcium<2.75 mmol/L (95% CI: 1.209-5.883). Conclusions:Double-hit patients are a highly specific group with worse high-risk MM prognosis. In such patients, the relapse is more common, the disease progression is faster, and the survival time is shorter than those in the non-double-hit patients.
8. Study on purification effect of formaldehyde in cleanroom by new return air device
Kaili XU ; Hong YANG ; Jingxin XIE ; Jianfeng WANG ; Weimin SHEN ; Chen LING ; Xiangjin FU ; Yuyang XIA ; Changyu HAN ; Lishi ZHONG ; Yuying FAN
Chinese Journal of Industrial Hygiene and Occupational Diseases 2019;37(5):347-351
Objective:
To effectively reduce the concentration of poisons in cleanroom, protect the health of workers, realize the optimization and automatic control of the new return air device. And the influence of initial concentration, air volume, temperature and relative humidity of formaldehyde on the purification effect of the new return air device was explored.
Methods:
The purification effect of the new return air device installed with the activated carbon and the photocatalyst purification net or ordinary activated carbon purification network was tested in a 60 m3 simulated cleanroom. The concentration of formaldehyde was determined by solution absorption-phenol reagent spectrophotometry. Based on the single factor experiment to determine the combination of two purification nets. The effects of air volume, initial formaldehyde concentration, temperature and relative humidity on the purification effect of the new return air device were investigated by orthogonal test. Then, the performance parameters of the return air device to purify formaldehyde were determined.
Results:
The formaldehyde purification efficiency of the two types of purification nets in the new return air device was higher than that of the ordinary activated carbon purification network (
9. Analysis of clinical characteristics and prognostic factors in elderly patients with acute myeloid leukemia
Weimin WANG ; Zhongxing JIANG ; Ling SUN ; Xinsheng XIE ; Jie MA ; Rong GUO ; Yanfang LIU ; Shengmei CHEN ; Hui SUN
Chinese Journal of Geriatrics 2019;38(9):1018-1023
Objective:
To investigate the clinical characteristics and prognostic factors in elderly patients with acute myeloid leukemia(AML).
Methods:
Clinical data of 232 patients with acute myelocytic leukemia(AML, except for acute promyelocytic leukemia) admitted in our hospital from January 2012 to December 2015 were retrospectively analyzed.Factors affecting complete remission(CR) were analyzed by using
10.The abnormalities demonstrated by spine MRI indicate the possibility of etiology for refractory lower urinary tract symptoms in female patients
Libo LIU ; Peipei ZHANG ; Qing LING ; Zongbiao ZHANG ; Peng CAO ; Lei XU ; Shengfei XU ; Hailang LIU ; Yong ZHANG ; Xiaoyi YUAN ; Liang WANG ; Weimin YANG ; Guanghui DU
Chinese Journal of Urology 2018;39(11):814-818
Objective To approach the spine MRI features and its possibility of etiology for refractory lower urinary tract symptoms(LUTS) in female patients.Methods We conducted prospectively a cross sectional description study of female patients with refractory LUTS during January 16 through March 27 in 2017 based on a urologist's outpatient work.The including criteria were adult female patients with refractory LUTS which defined as having LUTS more than three months and having poor response to behavior therapy and medication treatment.The excluding criteria were patients having evidence of infection,tumor,stone in urinary tract,any central nerve system diseases,or any other diseases may potentially producing LUTS.Data collected included patients demographic information,main complains,present disease features,disease history,physical examination,urine routine,urodynamic study and spine MRI.The characteristics of clinical manifestation,urodynamic study and spine MRI were analyzed.Results During the time span of study,totally 70 cases had been diagnosed as having refractory LUTS and had qualified data of clinical recordings,urodynamic study and spine MRI.Among these 70 cases,63 (90.9%) had storage phase symptoms,11 (15.7%) had voiding phase symptoms,8 (11.4%) had postmicturition symptoms,12 (17.1%) also had disorders in defecating,45 (64.3%) had pain in lower abdomen or pelvic region.69 cases (98.6%) had urodynamic disorders,33 (47.1%) had oversensitivity of bladder,12 (17.1%) had smaller bladder volume,16(22.9%) had detrusor overactivity,15 (21.4%) had bladder outlet obstruction,39(55.7%) had detrusor underactivity.69 cases(98.6%)had spine MRI abnormalities,54(77.1%) had sacral nerve lesions,49 (70.0%) had cervical lesions,48 (68.6%) had lumbar lesions,4 had thorathic lesions.Conclusions The present study revealed extraordinary high prevalence of abnormality in urodynamic parameters and spine MRI in female patients with refractory LUTS,which implies possibility that the refractory LUTS are caused by lesions in spinal nerve system.

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