【Objective】 To investigate the urinary tract characteristics of diabetes insipidus (DI) complicated with upper urinary tract dilatation (UUTD), and to summarize the treatment experience. 【Methods】 The clinical data of 28 DI patients treated in China Rehabilitation Research Center were retrospectively analyzed with UUTD and all urinary tract dysfunction (AUTD) systems to evaluate the urinary tract characteristics. The relevant laboratory results, video-urodynamic recordings (VUDS), UUTD, neurophysiologic tests, treatment regimens and follow-up data were summarized. 【Results】 There were 21 DI cases (75.0%) and 7 cases of DI with neurogenic bladder (NB). Polyuria, polydipsia, urine specific gravity, urine osmotic pressure and water deprivation vasopressin test had diagnostic value for DI. In addition, detailed history, neurological examination, VUDS and neurophysiologic tests had significant diagnostic value for DI with NB. Enterocystoplasty was recommended for 2 DI with NB patients with poor bladder capacity, compliance and renal impairment. For the remaining 26 patients, individualized medication combined with bladder neck incision and appropriate bladder management, including intermittent catheterization, catheter indwelling and regular voiding, achieved satisfactory results. High serum creatinine decreased from (269.8±105.7)μmol/L to (164.4±90.2)μmol/L in 13 patients with abnormal renal function. Forty-eight dilated ureters showed significant improvement in the UUTD grade, and the median grade decreased from 3 to 2. 【Conclusion】 Bladder distension, trabeculation and decreased or absent sensations were common features for DI patients with UUTD. Individualized therapy by medication combined with appropriate bladder management can improve the dilatation and renal function.

Purpose: We investigated the effectiveness of intravesical botulinum toxin-A (BTX-A) injection therapy in patients with lower urinary tract dysfunction (LUTD) and upper urinary tract (UUT) deterioration and evaluated whether BTX-A injection therapy could substitute for augmentation uretero-enterocystoplasty (AUEC). Methods: Data from a prospective, single-center cohort from 2017–2021 were analyzed. Patients were divided into 2 treatment groups: AUEC and BTX-A (i.e., patients who declined AUEC). Bladder and UUT functions were assessed by comparing clinical information, urodynamic data, laboratory results, and imaging records. Results: In total, 121 patients were enrolled (BTX-A group: 41 patients; AUEC group: 80 patients). The BTX-A group showed a reduced maximum detrusor pressure and increases in the maximum bladder volume and bladder compliance (P<0.05). However, in follow-up evaluations, significantly smaller improvements (all P<0.05) in urodynamic parameters were found in the BTX-A group than in the AUEC group. Notably, there was no significant improvement in vesicoureteral reflux (VUR; P=0.66) or upper urinary tract dilatation (UUTD; P=0.75) in the BTX-A group, and no statistically significant difference in serum creatinine (Scr) levels or the estimated glomerular filtration rate (eGFR) was observed in the follow-up evaluations (all P>0.05). Both VUR and UUTD improved significantly in the AUEC group, and the Scr and eGFR levels significantly improved after AUEC relative to baseline levels (P<0.05). The reduction in the Scr level was significantly lower in the BTX-A group than in the AUEC group during 0–15 months of follow-up (Scr reduction differences, -1.36; P<0.01). Conclusions Although BTX-A injection therapy was effective for improving bladder function, BTX-A injections did not alleviate UUT deterioration in this study, particularly in patients with advanced-stage LUTD. Conversely, AUEC for LUTD has a well-established role in improving UUT function. Hence, BTX-A injection therapy should not replace AUEC to ameliorate UUT impairment and protect UUT function.

Objective: To investigate the relationship between urinary monohydroxylated metabolites of hydroxyl polycyclic aromatic hydrocarbons (OH-PAHs) and lung function, as well as the role of oxidative stress in these associations, so as to provide a scientific basis for air pollution control and policy formulation. Methods: A panel study was carried out among 45 young healthy adults. Four follow up surveys and health examinations were conducted from November 2017 to October 2018 to measure lung function parameters [forced vital capacity (FVC), second forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), FEV1/FVC, and forced expiratory flow between 25% and 75% vital capacity (FEF 25%~75% )], markers of exposure to 7OHPAHs [∑ 7OH PAHs], and markers of oxidative stress[8 hydroxy 2 deoxyguanosine (8 OHdG) and 8 isoprostaglandin F 2α (8 iso PGF 2α )]. The relationship between urinary PAH metabolites and lung function was quantified by linear mixed effects models. Mediation analysis was performed to assess the role of oxidative stress in the relationship between OH PAHs and lung function. Results: The median values of FVC, FEV1, FEVI/FVC, PEF, and FEF 25%-75% were 4.37 L, 3.58 L, 83.00%, 4.38 L/s, and 3.32 L/s, respectively. The results showed that each 1 unit increase in log transformed value of 2 Hydroxyfluorene (2 OHFlu) was associated with a 5.05% decrease ( β %=-5.05%，95% CI =-8.85%--1.09%) in FVC, 4.15% decrease ( β %=-4.15%，95% CI =-7.94%- -0.22% ) in FEV1 and 5.87% decrease ( β %=-5.87%，95% CI =-11.35%--0.05%) in FEF 25%-75% , respectively. Each 1 unit increase in log transformed values of 2 OHFlu and 9 Phenanthrol (9 OHPhe) was associated with a 7.03% decrease ( β %=-7.03%，95% CI =-12.60%--1.11%) and a 7.08% decrease ( β%=-7.08%，95% CI =-13.50%--0.17%) in PEF, respectively. Additionally, urinary ∑ 7OH PAHs had a positive correlation with the levels of urinary 8 OHdG and 8 iso PGF 2α ( r =0.64, 0.69, P <0.01). Meanwhile, the levels of 8 OHdG mediated 17.06% and 15.71% of the association between 2 OHFlu with FVC and FEV1. Conclusion The finding reveales a negative relationship between urinary OH PAHs and lung function among young healthy adults. The 8 OHdG plays a mediated role in the correlation of 2 OHFlu with FVC and FEV1. Active relevant policies are needed to control air pollution and maintain the healthy living conditions of young people.

Purpose: To explore the effect of intravesical electrical stimulation (IVES) on urinary adenosine triphosphate (ATP) and nitric oxide (NO) in rats with detrusor underactivity (DU) induced by bilateral pelvic nerve crush (bPNC), and to determine the underlying peripheral mechanism. Methods: Twenty-four female Sprague-Dawley rats were equally divided into 3 groups: sham; bPNC; and IVES. Rats in the IVES group began to receive IVES treatment 10 days after bPNC (20 minutes per day for 14 consecutive days). After the 14th IVES, rat urine was collected and cystometry was performed. The serum creatinine, blood urea nitrogen, and urinary ATP and NO levels were measured, and a routine urinalysis was performed. Results: The maximum cystometric capacity (MCC), maximum changes in bladder pressure during filling (∆FP), and postvoid residual urine (PVR) in the IVES group were significantly lower than the bPNC group, and the maximum changes in bladder pressure during voiding (∆VP) was significantly higher than the bPNC group. Compared with the sham group, the MCC, ∆FP and PVR were significantly increased, and the maximum voiding pressure (MVP) and ∆VP were significantly decreased in the bPNC group. After bPNC, urinary ATP was significantly decreased, and urinary NO was significantly increased. In IVES-treated rats, urinary ATP was significantly higher than the bPNC group, and NO was significantly lower than the bPNC group. In addition, the ATP-to-NO ratio of the rats in the bPNC group was significantly lower than the sham and IVES groups. Correlation analysis showed that the ATP and NO were not correlated with the MCC, ∆FP, MVP, ∆VP, and PVR. Conclusions Promoting the release of urothelial ATP and inhibiting the release of urothelial NO may be one of the peripheral mechanisms underlying IVES in the treatment of DU. Specifically, IVES may shift the balance between excitation and inhibition toward excitation.

Objective:To investigate the clinical efficacy of B-mode ultrasound guided percutaneous extensor tendon insertion reconstruction in the treatment of tendinous mallet fingers.Methods:A retrospective analysis was performed on the data of patients with mallet finger deformity admitted to the Department of Hand Surgery of Jinan People’s Hospital from February 2010 to January 2019. Under the guidance of B-mode ultrasound, the extensor tendon was sutured percutaneously with PDS II monofilament suture, pulled to the base of the distal phalanx, which was drilled with a 1.0 mm Kirschner’s wire to reconstruct the insertion of the extensor tendon. The active and passive extension angles of the affected fingers and the wound healing were observed after operation. Evaluation of finger function using Crawford’s method.Results:A total of 58 cases were enrolled, including 48 males and 10 females, aged 20-53 years. 49 patients were followed up for 6 to 15 months after operation, with an average of 11 months, and 9 patients were lost to follow-up. The active extension angle of the affected finger changed from 46.5°±7.2° before operation to 6.4°±0.5° after operation, and the difference was statistically significant before and after operation ( t=38.89, P<0.001). The passive extension angle decreased from 3.2° ±0.3°before operation to 0.9° ±0.2°after operation, and the difference was statistically significant before and after operation ( t=44.65, P<0.001). There were no complications such as exposed knots and skin necrosis. Evaluation by Crawford method: excellent in 29 cases, good in 12 cases, and fair in 8 cases. Conclusions:Percutaneous ultrasound-guided extensor finger tendon insertion reconstruction, minimally invasive surgery, in the treatment of tendon mallet finger function recovered well, and the effect was satisfactory.

Objective:To investigate the clinical efficacy of B-mode ultrasound guided percutaneous extensor tendon insertion reconstruction in the treatment of tendinous mallet fingers.Methods:A retrospective analysis was performed on the data of patients with mallet finger deformity admitted to the Department of Hand Surgery of Jinan People’s Hospital from February 2010 to January 2019. Under the guidance of B-mode ultrasound, the extensor tendon was sutured percutaneously with PDS II monofilament suture, pulled to the base of the distal phalanx, which was drilled with a 1.0 mm Kirschner’s wire to reconstruct the insertion of the extensor tendon. The active and passive extension angles of the affected fingers and the wound healing were observed after operation. Evaluation of finger function using Crawford’s method.Results:A total of 58 cases were enrolled, including 48 males and 10 females, aged 20-53 years. 49 patients were followed up for 6 to 15 months after operation, with an average of 11 months, and 9 patients were lost to follow-up. The active extension angle of the affected finger changed from 46.5°±7.2° before operation to 6.4°±0.5° after operation, and the difference was statistically significant before and after operation ( t=38.89, P<0.001). The passive extension angle decreased from 3.2° ±0.3°before operation to 0.9° ±0.2°after operation, and the difference was statistically significant before and after operation ( t=44.65, P<0.001). There were no complications such as exposed knots and skin necrosis. Evaluation by Crawford method: excellent in 29 cases, good in 12 cases, and fair in 8 cases. Conclusions:Percutaneous ultrasound-guided extensor finger tendon insertion reconstruction, minimally invasive surgery, in the treatment of tendon mallet finger function recovered well, and the effect was satisfactory.

Objective:To investigate the clinical efficacy of B-mode ultrasound guided percutaneous extensor tendon insertion reconstruction in the treatment of tendinous mallet fingers.Methods:A retrospective analysis was performed on the data of patients with mallet finger deformity admitted to the Department of Hand Surgery of Jinan People’s Hospital from February 2010 to January 2019. Under the guidance of B-mode ultrasound, the extensor tendon was sutured percutaneously with PDS II monofilament suture, pulled to the base of the distal phalanx, which was drilled with a 1.0 mm Kirschner’s wire to reconstruct the insertion of the extensor tendon. The active and passive extension angles of the affected fingers and the wound healing were observed after operation. Evaluation of finger function using Crawford’s method.Results:A total of 58 cases were enrolled, including 48 males and 10 females, aged 20-53 years. 49 patients were followed up for 6 to 15 months after operation, with an average of 11 months, and 9 patients were lost to follow-up. The active extension angle of the affected finger changed from 46.5°±7.2° before operation to 6.4°±0.5° after operation, and the difference was statistically significant before and after operation ( t=38.89, P<0.001). The passive extension angle decreased from 3.2° ±0.3°before operation to 0.9° ±0.2°after operation, and the difference was statistically significant before and after operation ( t=44.65, P<0.001). There were no complications such as exposed knots and skin necrosis. Evaluation by Crawford method: excellent in 29 cases, good in 12 cases, and fair in 8 cases. Conclusions:Percutaneous ultrasound-guided extensor finger tendon insertion reconstruction, minimally invasive surgery, in the treatment of tendon mallet finger function recovered well, and the effect was satisfactory.

Objective:To investigate the clinical efficacy of B-mode ultrasound guided percutaneous extensor tendon insertion reconstruction in the treatment of tendinous mallet fingers.Methods:A retrospective analysis was performed on the data of patients with mallet finger deformity admitted to the Department of Hand Surgery of Jinan People’s Hospital from February 2010 to January 2019. Under the guidance of B-mode ultrasound, the extensor tendon was sutured percutaneously with PDS II monofilament suture, pulled to the base of the distal phalanx, which was drilled with a 1.0 mm Kirschner’s wire to reconstruct the insertion of the extensor tendon. The active and passive extension angles of the affected fingers and the wound healing were observed after operation. Evaluation of finger function using Crawford’s method.Results:A total of 58 cases were enrolled, including 48 males and 10 females, aged 20-53 years. 49 patients were followed up for 6 to 15 months after operation, with an average of 11 months, and 9 patients were lost to follow-up. The active extension angle of the affected finger changed from 46.5°±7.2° before operation to 6.4°±0.5° after operation, and the difference was statistically significant before and after operation ( t=38.89, P<0.001). The passive extension angle decreased from 3.2° ±0.3°before operation to 0.9° ±0.2°after operation, and the difference was statistically significant before and after operation ( t=44.65, P<0.001). There were no complications such as exposed knots and skin necrosis. Evaluation by Crawford method: excellent in 29 cases, good in 12 cases, and fair in 8 cases. Conclusions:Percutaneous ultrasound-guided extensor finger tendon insertion reconstruction, minimally invasive surgery, in the treatment of tendon mallet finger function recovered well, and the effect was satisfactory.

Objective:Evaluate the influence of different pressure transmission media of urodynamic water filled catheter(WFC) and air charged catheter(ACC) on the pressure measurement results to determine whether they can be used interchangeably.Methods:The results of 2 147 patients who underwent urodynamic examination in our hospital from January 2014 to December 2020 were retrospectively analyzed. A total of 2 538 times of bladder manometry data were obtained, including 1 299 times in WFC group, 856 times in male and 443 times in female, aged 37(24, 50)years, course of disease 1.2(0.4, 5.0) years, 1 130 times in neurogenic bladder(NB)and 169 times in non-neurogenic bladder(N-NB); In ACC group, there were 1 239 times, 773 times for male and 466 times for female, with age of 37(24, 55)years, course of disease of 1.5(0.5, 6.0)years, 1 040 times for Nb and 199 times for N-NB. There was no significant difference in baseline data of general clinical data between the two groups. The intravesical pressure(Pves), intra-abdominal pressure(Pabd)and detrusor pressure(Pdet) of WFC and ACC patients during filling and urination were analyzed. For traumatic spinal cord injury(SCI) and idiopathic patients, the two sets of pressure measurement data were analyzed separately. Nonparametric test and Chi-square test were used to compare the Pves, Pabd, and Pdet recorded by the two manometry catheters before, at the end and after urination, the maximum detrusor pressure at DO(Pdet.max-DO), and the maximum detrusor pressure during spontaneous urination (Pdet. max) and the detrusor pressure (Pdet.Qmax) corresponding to the maximum urine flow rate, the maximum urethral pressure (MUP) and the maximum urethral closure pressure (MUCP) during resting urethral pressure profile, and the initial cough Pdet signal pattern (typeⅠ, typeⅡand typeⅢ).Results:Regardless of the cause, the Pabd values measured by ACC were significantly higher than WFC before filling, end filling and after voiding[18(10, 26)cmH 2O vs.15(11, 21)cmH 2O; 23(16, 31)cmH 2O vs. 20(14, 26)cmH 2O; 23(15, 31)cmH 2O vs.18(12, 24)cmH 2O], and Pdet were significantly lower than WFC[0(0, 0) cmH 2O vs. 0(0, 1)cmH 2O; 5(1, 13)cmH 2O vs. 9(4, 17)cmH 2O; 6(1, 12)cmH 2O vs. 7(3, 14)cmH 2O]. In the initial cough state, Pves and Pabd increase value were also significantly lower than that of WFC [22(12, 36)cmH 2O vs. 23(14, 38)cmH 2O; 20(10, 33)cmH 2O vs. 21(12, 36)cmH 2O]. The Pves measured by ACC was also significantly higher than WFC before filling and after voiding[18(10, 27)cmH 2O vs. 16(11, 21)cmH 2O; 30(22, 39)cmH 2O vs. 26(20, 36)cmH 2O]. Maximum urethral pressure (MUP) and maximum urethral closure pressure (MUCP) measured by ACC were significantly higher than WFC [91(69, 118)cmH 2O vs.81(64, 106)cmH 2O; 77(55, 103)cmH 2O vs. 68(48, 91)cmH 2O], and there were no significant differences in Pdet.max-DO、Pdet.max和Pdet.Qmax. For patients with traumatic SCI, the Pves measured by ACC was significantly higher than WFC before filling[15(10, 24)cmH 2O vs. 14(10, 20)cmH 2O], and only MUP was significantly higher than WFC in the measurement of urethral pressure[95(71, 119)cmH 2O vs. 85(65, 112)cmH 2O], and there were no significant differences in Pdet.max-DO, Pdet.max, Pdet.Qmax and MUCP. For idiopathic patients, Pves measured by ACC before filling and after urination were significantly higher than WFC[25(20, 29)cmH 2O vs. 18(11, 23)cmH 2O; 35(29, 44)cmH 2O vs. 28(20, 38)cmH 2O], while Pdet.max-DO, Pdet.max, Pdet.Q max, MUP and MUCP were not significantly different in different pressure measurement systems. For the comparison of the initial cough Pdet signal pattern, ACC is easier to detect type Ⅰ, and WFC is easier to detect type Ⅱ and type Ⅲ. Conclusions:Compared with WFC, ACC measured higher Pves and Pabd and lower Pdet in resting state, and lower Pves and Pabd in initial cough state. The pressure values and signal pattern measured by WFC and ACC are not completely consistent, so they cannot be used interchangeably.

BACKGROUND: Chronic kidney disease is a severe threat to human health with no ideal treatment strategy. Mature mammalian kidneys have a fixed number of nephrons, and regeneration is difficult once they are damaged. For this reason, developing an efficient approach to achieve kidney regeneration is necessary. The technology of the combination of decellularized kidney scaffolds with stem cells has emerged as a new strategy; however, in previous studies, the differentiation of stem cells in decellularized scaffolds was insufficient for functional kidney regeneration, and many problems remain. METHODS: We used 0.5% sodium dodecyl sulfate (SDS) to produce rat kidney decellularized scaffolds, and induce adipose-derived stem cells (ADSCs) into intermediate mesoderm by adding Wnt agonist CHIR99021 and FGF9 in vitro. The characteristics of decellularized scaffolds and intermediate mesoderm induced from adipose–derived stem cells were identified. The scaffolds were recellularized with ADSCs and intermediate mesoderm cells through the renal artery and ureter. After cocultured for 10 days, cells adhesion and differentiation was evaluated. RESULTS: Intermediate mesoderm cells were successfully induced from ADSCs and identified by immunofluorescence and Western blotting assays (OSR1 + , PAX2 +). Immunofluorescence showed that intermediate mesoderm cells differentiated into tubular-like (E-CAD + , GATA3 +) and podocyte-like (WT1 +) cells with higher differentiation efficiency than ADSCs in the decellularized scaffolds. Comparatively, this phenomenon was not observed in induced intermediate mesoderm cells cultured in vitro. CONCLUSION: In this study, we demonstrated that intermediate mesoderm cells could be induced from ADSCs and that they could differentiate well after cocultured with decellularized scaffolds.
Animals ; Blotting, Western ; Fluorescent Antibody Technique ; Humans ; In Vitro Techniques ; Kidney ; Mesoderm ; Nephrons ; Rats ; Regeneration ; Renal Artery ; Renal Insufficiency, Chronic ; Sodium Dodecyl Sulfate ; Stem Cells ; Ureter