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An Fe-catalyzed unprotected hydroxylamine mediated Heck-type coupling between sulfinic acids and alkenes furnished structurally important (E)-vinyl sulfones with moderate to good yields, high atom-economy and regioselectivity.

Based on the study of the content, forms, and spatial distribution of phosphorus (P) in the surface and columnar sediments of the Sihe River, the relationships between the total phosphorus (TP) and various forms of P and the basic physical and chemical properties of sediment and their ecological significance were deeply discussed. The forms of P in the sediment were defined including soluble and loosely bound P (S/L-P), Al-bound P (Al-P), Fe-bound P (Fe-P), reductant soluble P (RS-P), Ca-bound P (Ca-P), and residual P (RES-P) using the method of selectively sequential extraction. The results indicated that

Cadmium (Cd) pollution is one of the most serious heavy metal pollutions in the world, which has been demonstrated to cause different toxicities to living organisms. Cd has been widely suggested to cause reproductive toxicity to vertebrates, yet its reproductive toxicity to invertebrates is not comprehensive. In this study, the wolf spider Pardosa pseudoannulata was used as a bioindicator to evaluate the male reproductive toxicity of invertebrates under Cd stress. Cd stress had no effect on the color, size and length of testis. However, Cd significantly increased the contents of catalase, glutathione peroxidase and malondialdehyde, the antioxidants in the testis of P. pseudoannulata. Then we analyzed the transcriptome of testis exposed to Cd, and identified a total of 4739 differentially expressed genes (DEGs) compared to control, with 2368 up-regulated and 2371 down-regulated. The enrichment analysis showed that Cd stress could affect spermatogenesis, sperm motility, post-embryonic development, oxidative phosphorylation and metabolism and synthesis of male reproductive components. At the same time, the protein-protein interaction network was constructed with the generated DEGs. Combined with the enrichment analysis of key modules, it revealed that Cd stress could further affect the metabolic process in testis. In general, the analysis of testicular damage and transcriptome under Cd stress can provide a novel insight into the reproductive toxicity of Cd on rice filed arthropods and offer a reference for the protection of rice filed spiders under Cd pollution.

Icaritin has potential anticancer effects on various cancers, including multiple myeloma (MM). Recent studies claim that Icaritin can regulate the expression of noncoding RNAs (ncRNAs) in cancer development. This study aimed to investigate the role of circular RNA_0000190 (circ_0000190) and functional mechanism in Icaritin-treated MM. The expression of circ_0000190 and miR-301a was detected by quantitative real-time polymerase chain reaction. Cell cycle, apoptosis, migration, and invasion were investigated using flow cytometry assay, and transwell assay, respectively. The expression of BAX, BCL2, MMP2, and CCND1 was detected by western blot. The predicted target relationship between circ_0000190 and miR-301a was validated by dual-luciferase reporter assay and RNA immunoprecipitation assay. The activation of JAK1/STAT3 pathway was examined using western blot. Circ_0000190 was strikingly downregulated in MM specimens and cell lines, and Icaritin promoted the expression of circ_0000190. In function, circ_0000190 overexpression promoted MM cell cycle arrest and apoptosis but restrained the ability of migration and invasion. Icaritin blocked the development of MM by increasing circ_0000190 expression. MiR-301a was identified as a target of circ_0000190, and miR-301a reintroduction largely abolished the effects of circ_0000190 overexpression. The activation of JAK1/STAT3 pathway was promoted by miR-301a restoration. Icaritin played anticancer effects in MM partly by enhancing the expression of circ_0000190 and regulating the circ_0000190/miR-301a pathway. This study enhanced the understanding of the mechanism of Icaritin associated with circRNAs in MM.

To evaluate the efficacy and safety of solifenacin in the treatment of bladder spasms after urethroplasty. Patients underwent urethroplasty were randomly assigned to the study group ( n = 165) and the control group ( n = 150). Patients in the study group were treated with solifenacin for 7 days. Patients in the control group were placebo. Each group was further divided into four subgroups: paracentetic suprapubic cystostomy subgroup, traditional suprapubic cystostomy subgroup, former suprapubic cystostomy subgroup, and urethral catheter subgroup. A visual analogue scale (VAS) was used to measure the severity of bladder spasms. The mean duration of spasms, the frequency of spasms, and the incidences of urine extravasation and radiating pain were recorded each day. There were no significant differences in the VAS scores and mean duration of bladder spasms between the study and control groups . However, there was a significantly lower VAS score in the patients taking solifenacin in the paracentetic suprapubic cystostomy subgroup ( p < .05). A similar tendency was noted in the mean duration of bladder spasms in this subgroup. In a comparison of the daily and nightly frequency of spasms within the four subgroups, a significant improvement was noted in the control group within 5 days. A similar difference was not noted within 6 days in the study group. The short-term therapy with solifenacin is an effective and safe method for decreasing the frequency of bladder spasms after urethroplasty. Patients undergoing paracentetic suprapubic cystostomy might be the only subset to benefit from this treatment.

BACKGROUND Cystostomy, endoscopic realignment, and emergency anastomosis are three methods used to treat bulbous urethral injury (BUI). The aim of the study is to determine the optimal management. METHODS A retrospective study was performed on 328 male patients with blunt straddle injury to the perineum. In total, 304 patients were included in the analysis due to strict criteria. Among these 304 patients, 197 had partial urethral disruption diagnosed, and 107 had complete urethral disruption. Group placement of the patients was based on the extent of injury. Each group was further divided into two subgroups based on the immediate management. Propensity score matching was used to correct for differences in baseline characteristics. RESULTS In the partial disruption group, the propensity score-matched subgroups set comprised of 164 patients. Of the 82 patients treated with endoscopic realignment, 34 (41.5%) patients required no urethral surgery, in contrast to 12 (14.6%) patients with cystostomy (p 0.05). In the complete disruption group, the propensity score-matched subgroups set comprised of 104 patients. The success rate of emergency anastomosis was 90.4% (47 patients), and urethral stricture occurred in five patients (96%), while urethral stricture developed in all 52 patients in the cystostomy subgroup. With regard to surgical management of complications, the choice of management methods significantly differed between the two subgroups (all, p < 0.05). The time to natural urination and duration of hospital stay were significantly shorter in the emergency anastomosis subgroup (29.1 ± 5.4 days vs. 57.1 ± 6.4 days; 7.2 ± 3.1 days vs. 12.5 ± 2.3 days; each p < 0.05). CONCLUSION Endoscopic realignment is associated with a lower stricture rate than cystostomy as immediate management for partial disruption. Emergency anastomosis provides better clinical outcomes for patients with complete disruption. LEVEL OF EVIDENCE Therapeutic Level IV.

Objective To investigate the long-term outcome of ileal ureteric replacement using a proximal antirefluxing technique for the treatment of long-segment ureteric strictures. Patients and methods Between January 1997 and December 2013, 41 patients with a long ureteral stricture or defect and 3 patients with unilateral mid-lower ureteral cancer (20 bilateral and 24 unilateral, 28 males and 16 females) were treated by ureteral substitution using a proximal antirefluxing technique. The distal part of the upper ureter (4 cm) was fixed between the psoas muscle and the ileal segment (the iliopsoas tunnel technique). The distal ileum was connected to the urinary bladder with an end-to-side anastomosis. A successful outcome was defined as the absence of major complications, worsening baseline renal function, metabolic derangements, or obstruction. Results One patient with unilateral mid-lower ureteral cancer died 3 years postoperatively because of metastasis, and the remaining 43 patients were followed for 12-180 months (mean 69 months). Intravenous urography showed that the hydronephrosis improved significantly or disappeared after 6-12 months in 34 patients, with improvement in 9 patients. Cystography showed no evidence of ileoureteral reflux. Seven patients needed long-term oral alkalization to prevent hyperchloremic acidosis. Conclusion In our experience, outcomes following subtotal ureteric replacement are encouraging. The ileal ureter replacement by the proximal antirefluxing technique appears to be a reliable procedure for treating long-segment ureteral stricture and preservation of renal function.

// XuFeng Peng 1, * , Bo Hao 3, * , Nailong Cao 1 , Jihong Wang 1 , Xiangguo Lv 2 and XinRu Zhang 1 1 Department of Urology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai 200233, China 2 Department of Urology and Andrology, Shanghai Renji Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200001, China 3 Department of Cardiothoracic Surgery, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China * These authors have contributed equally to this work Correspondence to: XinRu Zhang, email: 15800558925@163.com Xiangguo Lv, email: chnlvsc@163.com Keywords: ADAM17; cancer; prognosis; lymph node metastasis; distant metastasis Received: July 15, 2017 Accepted: December 26, 2017 Published: January 02, 2018 ABSTRACT ADAM17 (a disintegrin and metalloproteinase 17) is overexpressed in many types of cancer, and its high expression in cancer patients is associated with increased risk of metastasis and a poorer prognosis. However, the clinical value of ADAM17 as a tumor biomarker remains largely unknown. In this meta-analysis, we investigated the relationships between ADAM17 levels, cancer metastasis, and patient prognosis. Twelve eligible studies involving a total of 1816 patients were identified in searches of the PubMed, Embase, Cochrane, and Chinese National Knowledge Infrastructure databases. Analysis of these studies revealed that ADAM17 overexpression is positively associated with lymph node metastasis in a fixed effect model and distant metastasis in a random effect model. Moreover, high ADAM17 expression was predictive of shorter overall and progression-free survivalof cancer patients in fixed effect models. These results suggest that ADAM17 maybe a useful biomarker for predicting metastasis and prognosis in cancer patients and may also aid in risk stratification and selection of individualized treatments.

Cisplatin is a commonly used chemotherapy drug for prostate cancer (PC). However, some PCs are resistant to cisplatin treatment, while the molecular mechanisms underlying the resistance of PCs to cisplatin are not completely understood. In this study, we found that cisplatin dose-dependently activated Beclin-1 in two PC cell lines, PC3 and LNCap. Autophagy suppression significantly increased the cisplatin-induced cell death of these PC cells in a CCK-8 assay. Moreover, microRNA (miR)-144 levels were significantly downregulated in cisplatin-treated PC cells, in a VEGF-dependent manner. Bioinformatics analysis showed that miR-144 targeted the 3'-UTR of Beclin-1 mRNA to inhibit its translation, which was confirmed by luciferase reporter assay. In PC patients after cisplatin treatment, low miR-144 levels appeared to predict poor outcome of patients' survival. Together, these data suggest that cisplatin may induce VEGF to suppress miR-144 levels in PC cells, which subsequently upregulates Beclin-1 to increase autophagic cell survival against cisplatin-induced cell death. Upregulation of miR-144 or suppression of cell autophagy may improve the outcome of cisplatin therapy in PC.

Microalgae, in wet conditions, tend to grow on surfaces and form biofilms. The adhesion of microalgae to surfaces is very important for algal mass culture. The formation and development of microalgal biofims are in large denpend on the properties of cell surface, substratum surface and gowth medium. In this paper, the influence of substratum surface zeta potential on the microalgal biofilms was particularly investigated. We focused on a widely-used microalgal strain, the freshwater autotrophicChlorella sp..The adhesion phenomena ofChlorella sp.to surfaces with different zeta potential were observed microscopically. It was found thatChlorella sp.adhered easily to the surface with a positive zeta potential and difficultly to the surface with a negative zeta potential. We concluded that the surface zeta potential had a greater influence on the adhesion of microalgal cells to substratum surfaces. Our findings have important implications for microalgae mass culture and harvesting.

Rheological properties of microalgae suspensions affect the mixing and mass transport in photobioreactor systems and the design of downstream biomass processing technologies，and directly impact the energy demand and system performance of algae biofuel production. The purpose of this paper is to obtain the rheological properties as a function of volume fraction. The volume fractions of microalgae suspensions φ were derived according to the size distribution of the microalgae cells and cell number concentrations per cubic meter liquid. We found that at low concentrations, microalgae suspensions display a Newtonian fluid behavior. At high concentrations, microalgae suspensions behave as a shear thinning non-Newtonian fluid. The results are of potential scientific relevance and also useful in relation to the design of algae bioprocessing for the large scale production of economic biofuels.

This article studies in detail the permeation properties of highly permeable and highly selective polymer membrane for water vapor/volatile organic compound (VOC). A dense cellulose acetate (CA) membrane is prepared by the dry method. The sorption and permeation properties of water vapor and VOCs (acetic acid, formaldehyde, acetaldehyde, toluene and ethane) are experimentally investigated. Besides, the mass transfer coefficient of self-membrane can be separated from the total mass transfer coefficient. Using sorption and permeation data of gases, diffusion coefficient is calculated based on a solution–diffusion mechanism. The selectivity for water vapor/VOC is discussed and analyzed. The permeability selectivities of water vapor/VOC are all over 100. The result shows that the novel CA sense membrane is suitable for air dehumidification and total heat recovery. Copyright , Oxford University Press.

Salidroside is known for its pharmacological properties and in particular its antioxidation effects. In recent years, it has been recognized that salidroside plays an important role in treating diabetes. Accumulated evidence suggests that microRNAs may be involved in diabetic lipid disorders. We investigated how salidroside regulates lipid metabolism through miR-370 in vivo and in vitro. After 4 weeks of a high-fat diet, and intraperitoneal injection of streptozotocin (100mg/kg), type 2 diabetes was induced in male C56BL/6J mice. After 4 weeks, mice with fasting blood glucose levels above 7.8mmol/l were divided into five groups: those with diabetes mellitus, and those treated with 40mg/kg, 80mg/kg, and 160mg/kg salidroside, and metformin (480mg/kg), for a further 4 weeks. The hypoglycemic effects of salidroside were consistently demonstrated when measuring fasting blood glucose levels, observing insulin-sensitizing effects, and testing oral glucose tolerance. In addition to this, the expressions of miR-370, and related lipid protein expression in primary hepatocytes, were examined in primary type 2 diabetic mice. The present study has shown that the expression levels of miR-370, SREBP-1 and FAS-1 were significantly elevated in the liver of type 2 diabetic mice. In contrast, the elevated expression levels were reversed by salidroside. The addition of salidroside attenuated the effect of miR-370, and reduced the expression of these lipid metabolism proteins in primary hepatocytes. These findings demonstrate that salidroside can directly decrease the expression of miR-370 in type 2 diabetic mice, and particularly in primary hepatocytes, affecting lipid metabolism in the liver.

UNLABELLED Fresh air ventilation is central to indoor environmental control. Total heat exchangers can be key equipment for energy conservation in ventilation. Membranes have been used for total heat exchangers for more than a decade. Much effort has been spent to achieve water vapor permeability of various membranes; however, relatively little attention has been paid to the selectivity of moisture compared with volatile organic compounds (VOCs) through such membranes. In this investigation, the most commonly used membranes, both hydrophilic and hydrophobic ones, are tested for their permeability for moisture and five VOCs (acetic acid, formaldehyde, acetaldehyde, toluene, and ethane). The selectivity of moisture vs. VOCs in these membranes is then evaluated. With a solution-diffusion model, the solubility and diffusivity of moisture and VOCs in these membranes are calculated. The resulting data could provide some reference for future material selection. PRACTICAL IMPLICATIONS Total heat exchangers are important equipment for fresh air ventilation with energy conservation. However, their implications for indoor air quality in terms of volatile organic compound permeation have not been known. The data in this article help us to clarify the impacts on indoor VOC levels of membrane-based heat exchangers. Guidelines for material selection can be obtained for future use total heat exchangers for building ventilation.

A one-step approach is employed to prepare an asymmetric cellulose acetate (CA) membrane that is used for total heat recovery (heat and moisture recovery). The process only involves a cheap raw material of CA, an environmental friendly solvent acetic acid and an additive deionized water. A porous support layer and a dense skin layer are formed simultaneously during the solvent and coagulant medium exchange. Investigations found that the approach is successful in making membranes for heat and moisture recovery. The new membranes have high moisture permeability. Moreover, the permeation of other unwanted gases like CO2 is effectively prohibited. Analysis found that the optimum solution compositions for casting membranes are: acetic acid to deionized water ratio 70:30. The approach provides an environmental friendly yet economical solution for preparing membranes for heat and moisture recovery.

Objectives We evaluated the efficacy of bulbourethral composite sling procedure in the treatment of male urinary incontinence after radical prostatectomy, transurethral resection of the prostate, or prostatic enucleation for benign prostatic hyperplasia, and posterior urethroplasty. Methods Between May 2000 and April 2005, a bulbourethral composite sling was performed in 26 patients with acquired urinary incontinence. Eight (30.8%) of these patients had severe urinary incontinence, and 18 (69.2%) had mild to moderate urinary incontinence. A polyester patch plus tension-free vaginal tape (TVT) device was used in the procedure. Prolene threads were attached to the two ends of polyester taper then passed from the perineal incision to a suprapubic incision with a TVT needle. The ends of the sutures and TVT were tied over the rectus fascia in the midline after repeated urethral pressure measurements reached 80–90cmH 2 O. Results The follow-up period was 8–54 mo (mean: 28.3). The primary procedure failed in one patient. Of the remaining 25 patients, 1 patient died of cerebral hemorrhage 2 yr postoperatively, and 2 patients had recurrent stress incontinence in 1.5 and 2 yr postsurgery, respectively. The recurrent incontinence was severe in one patient and mild (one to two pads per day) in the other. The remaining 22 patients maintained urination and continence. The total success rate (cure and improved) was 92% (23 of 25). Conclusions Bulbourethral composite sling procedure is a minimally invasive, safe, effective surgical option in the treatment of male patients with mild to moderate incontinence, but is not suitable for severe incontinence. Temporary perineal discomfort or pain is a common complication of the procedure.

Until now, various laser types have been used in the treatment of bladder cancer. The purpose of this study is to evaluate the feasibility and effectiveness of 2 μm continuous-wave (CW) thulium laser in treating primary non-muscle-invasive bladder cancer (NMIBC).A comparative (randomized prospective) interventional study was conducted in our center. A total of 400 patients with Ta or T1 bladder cancer were enrolled and randomized to transurethral resection of bladder tumor (TURBT) or laser vaporesection (LVRBT). Patients in the TURBT group received standard transurethral resection with a bipolar electrocautery system, while those in the LVRBT group received transurethral vaporesction with a 2 μm CW thulium laser. All patients received intravesical irrigation with sterile water for at least 12 h immediately after the procedure. The end-points of this study were tumor recurrence and/or progression, or the completion of 36 months of follow-up (10 cystoscopies) with no recurrence.A total of 292 patients were included in our analysis, of whom 143 received TURBT and 149 received LVRBT. During 36 months of follow-up, 129 cases (44.2%) had recurrence: 61 (42.7%) in the TURBT group and 68 (45.6%) in the LVRBT group (p = 0.608). Tumor progression was found in 19 patients (6.5%): 11 in the TURBT (7.7%) and 8 (5.4%) in the LVRBT group (p = 0.421). Median tumor-free survival was 25.2 months (25.46 in the TURBT group vs. 24.9 in the LVRBT group, p = 0.729). Overall recurrence rate was 14.7%, 42.1%, and 62.5% in the low, intermediate low, and intermediate high risk subgroups, respectively. Operation time was significantly lower in the TURBT than in the LVRBT group (28.43 vs. 31.5 min, p = 0.044).Use of a 2 μm CW thulium laser is feasible and effective in treating primary NMIBC. With a cystoscopic biopsy of the bladder muscle, 2 μm CW thulium laser could retrieve sufficient diagnostic and prognostic specimens.

The relationship between chronic prostatitis and fertility has been disputed for many years. Several groups have shown infection and autoimmune response against prostate antigens could have a deleterious effect on semen quality and fertility. This study was conducted to test the hypothesis that Omi/HtrA2-induced apoptosis in chronic prostatitis could be a mechanism underlying the observed clinical benefit. The Omi/HtrA2 serine protease is a nuclear-encoded mitochondrial protein, which can be released from mitochondria into the cytosol after apoptosis stimuli, inducing apoptosis in caspase-dependent and independent manners. Forty-one patients diagnosed as suffering from chronic prostatitis were included. Healthy normal individuals were included as controls. Human spermatozoa in the semen were purified by Percoll-gradient technique to separate the seminal plasma and other round cells. Measurements for sperm concentration, motility, morphology, proinflammatory cytokines, Omi/HtrA2 mRNA and protein levels in spermatozoa of chronic protatitis patients, were performed accordingly. Significantly increased levels of proinflammatory cytokines were detected in seminal plasma from these prostatitis patients. Omi/HtrA2 mRNA and protein levels were significantly higher in prostatitis men than in normal men. This study shows that chronic prostatitis patients present important alterations in their semen quality parameters, Omi/HtrA2 mRNA and protein levels of spermatozoa. We speculate that the inflammatory process involved may affect male fertility by release of proapoptotic protein Omi/HtrA2.

Purpose: To construct a reliable continent tube, which is easy to catheterize and surgically simple. Materials and Methods: 8 adult female mongrel dogs underwent a procedure in which an ileal segment was tapered as an efferent tube. The tapered ileum was fixed to the back surface of the rectus muscle with a polyester taper 1.5 cm in width and a suspension tension of 400 g. The internal orifice of the tapered ileum was anastomosed to the bladder and the external orifice of the tapered ileum was brought out to the abdominal skin. Urodynamic and radiological studies were carried out postoperatively in all dogs. Results: All stomas in dogs could be easily catheterized with a 14-french catheter. Urodynamic study of the efferent tubes showed that the maximum closure pressure ranged from 117 to 157 (mean 136.75) cm water. Retrograde radiogram of the efferent tubes showed perfect canalization without stenosis. Conclusion: This study suggests that the continent mechanism of the tapered ileum can be greatly enhanced by a suspension technique.

Purpose: We constructed a reliable continent tube that is easy to catheterize and surgically simple.Materials and Methods: Eight patients with bladder cancer underwent a procedure in which ileal segment was tapered as an efferent tube, of which a part was placed between the back surface of the rectus muscle and the ileal pouch wall. The internal orifice of the tapered ileum was anastomosed to the ileal pouch and its external orifice was anastomosed to the umbilicus. Urodynamic and radiological studies were done postoperatively in 7 cases.Results: The stoma was easily catheterized with a 16Fr catheter in all cases. One patient died of heart disease 55 days postoperatively, while 6 of the remaining 7 were completely continent day and night. Urodynamic study of the efferent tubes showed that maximum close pressure with the pouch full was significantly higher than with the pouch empty (p

Male urinary incontinence is relatively common complication of radical prostatectomy and of posterior urethroplasty following traumatic pelvic fracture. Here, we investigate the use of pedicled rectus abdominis muscle and fascia flap sling of the bulbar urethra for treatment for male-acquired urinary incontinence. Ten patients with acquired urinary incontinence were included in the study. Urinary incontinence was secondary to TURP in three patients and was secondary to posterior urethroplasty performed following traumatic pelvic fracture in seven patients. Pedicled rectus abdominalis muscle and fascial flaps, approximately 2.5 cm wide and 15 cm long, were isolated. The flaps were inserted into a perineal incision through a subcutaneous tunnel. The free end of the flap was sectioned to form two muscle strips, each 3 cm in length, and inserted into the space between bulbar urethra and corpus cavernosa. After adequate sling tension had been achieved, the two strips of muscle were anastomosed around the bulbar urethra using a 2-zero polyglactin suture. The patients were followed up for between 12 and 82 months (mean 42.8 months). Complete continence was achieved with good voiding in seven of the 10 patients. In other three patients achieved good voiding following catheter removal, but incontinence was only moderately improved. A pedicled rectus muscle fascial sling of the bulbar urethra is an effective and safe treatment for male patients with mild to moderate acquired urinary incontinence, but it may not be suitable for severe incontinence or for patients with weak rectus abdominalis muscles.

To observe the oxidative stress of serum, lung and heart tissues in rats caused by PM10.In the study,24 male Wistar rats weighed 320-360 g were randomly divided into four groups, including one saline control group and three PM10 exposed groups. PM10 was administered to the exposed groups by intratracheal instillation at the doses of 3.75, 7.5, 15 mg/kg, respectively. The rats were sacrificed 24 hours after exposure. The levels of MDA and activities of SOD in the serum, lung and heart tissues were measured. In addition, the contents of protein carbonyl in lung and heart tissues were determined.The activities of SOD in the serum, lung and heart tissues decreased markedly in the 7.5 and 15 mg/kg groups. The levels of MDA in the lung tissues significantly increased in the 7.5 and 15 mg/kg groups, while those in the serum and heart tissues significantly increased only in the 15 mg/kg group. The contents of protein carbonyl in the lung tissues markedly increased in the 15 mg/kg group, but no significant change was found in the heart tissues.The study showed that PM10 can cause oxidative stress effects in rats. The lipids of cell membrane are more susceptible to oxidative stress than the proteins.

Continent cutaneous diversion (CCD) has been widely used in almost any lower urinary reconstruction. We have been continually trying to modify this procedure because of the high complications rate, especially as they relate to the efferent tube. In this study, we reported a modified procedure with a tapered ileum wrapped by the rectus abdominalis flap (RAMF) and assessed the feasibility of this new technique to achieve urinary continence.A procedure in which two ileal segments were tapered and connected to a U-shaped reservoir was performed in ten dogs. A RAMF with its blood supply was wrapped around one of the tapered ileum. In control groups, the tapered ileum was brought to the abdominal skin. Urodynamic studies were conducted In the 1st, 3rd and 6th months post-operatively. The data of maximum inner pressure (MIP) and functional pressure length (FPL) in every group at each phase were recorded. Retrograde radiograms of the efferent limbs were performed before sacrifice.MIP in the study group was significantly higher than that in the control group at each phase (P0.05). However, no significant differences in MIP or FPL were found in the study group between an empty and full reservoir. In the control group, MIP increased (P0.05) and FPL decreased significantly (P0.05) compared with an empty and full reservoir. Retrograde radiograms confirmed that efferent limbs were positioned straigh beneath the abdominal wall. Histological examination of the study group demonstrated a layer of striated muscle around the outside surface of the ileum.The continent mechanism of tapered ileum can be enhanced by extra support from wrapped RAMF.

To evaluate the influence of reconstructive surgery for male urethral stricture on erectile function and sexual life quality.We analyzed retrospectively the clinical data of 326 male patients who underwent urethroplasty for urethral stricture in our department and evaluated their erectile function and sexual life quality.A total of 172 groups of valid data were collected, with the mean follow-up of 28.5 months. The mean scores on IIEF-5 (P=0.002) and sexual life quality (P=0.026) were statistically significantly reduced after surgery. Erectile dysfunction was found in 88 (51.2%) of the patients after urethroplasty, as compared with 56 (32.6%) preoperatively.The location of urethral stricture, surgical method and urethral stricture recurrence may affect the erectile function and sexual life quality of the patient, but both can be gradually improved with the time after urethroplasty.

To study the etiopathogenesis and management of seminal vesicle enlargement.Forty-six cases of seminal vesicle were selected, of which 36 were vesiculitis, treated by antibiotics through a catheter indwelt in the seminal vesicle for 1 week, 3 were cystic vesicular seminalis, given anti-inflammatory treatment by catheter administration and hydatid fluid inhalation, 1 was calculus at the orifice of the ejaculatory duct, taken out by transurethral resection of the verumontanum, 1 was polypous at the orifice of the verumontanum, removed by transurethral resection, 2 were posterior urethritis, treated by fulguration, and 3 were prostatic carcinoma, treated by radical prostatectomy and spermatocystotomy.Hemospermia disappeared in 32 cases of vesiculitis during the 6-24 months follow-up, 4 cases experienced recurrent hemospermia 3 months after the treatment. No recurrence was observed in any other case of cystic vesicular seminalis, calculus, polypous, posterior urethritis and prostatic carcinoma.Seminal vesicle enlargement has intricate etiopathogenesis, but can be treated with satisfactory results if managed properly.

Objectives We evaluated the applications and outcomes of substitution urethroplasty, using a variety of techniques, in 65 patients with complex, long-segment urethral strictures. Methods From January 1995 to December 2005, 65 patients with complex urethral strictures >8cm in length underwent substitution urethroplasty. Of the 65 patients, 43 underwent one-stage urethral reconstruction using mucosal grafts (28 colonic mucosal graft, 12 buccal mucosal graft, and 3 bladder mucosal graft), 17 patients underwent one-stage urethroplasty using pedicle flaps, and 5 patients underwent staged Johanson's urethroplasty. Results The mean follow-up time was 4.8 yr (range; 0.8–10 yr), with an overall success rate of 76.92% (50 of 65 cases). Complications developed in 15 patients (23.08%) and included recurrent stricture in 7 (10.77%), urethrocutaneous fistula in 3 (4.62%), coloabdominal fistula in 1 (1.54%), penile chordee in 2 (3.08%), and urethral pseudodiverticulum in 2 (3.08%). Recurrent strictures and urethral pseudodiverticulum were treated successfully with a subsequent procedure, including repeat urethroplasty in six cases and urethrotomy or dilation in three. Coloabdominal fistula was corrected only by dressing change; five patients await further reconstruction. Conclusions Penile skin, colonic mucosal, and buccal mucosal grafts are excellent materials for substitution urethroplasty. Colonic mucosal graft urethroplasty is a feasible procedure for complicated urethral strictures involving the entire or multiple portions of the urethra and the technique may also be considered for urethral reconstruction in patients in whom other conventional procedures failed.

To evaluate the selection of different procedures and the feasibility for the treatment of long segment urethral stricture.Seventy-six patients with complex urethral stricture greater than 8 cm long underwent different procedures of urethroplasty. Of them various mucosa grafts urethral reconstruction were adopted in 42 cases (colonic mucosal graft, n = 26; buccal mucosal graft, n = 10; bladder mucosal graft, n = 6); One-stage pedicle flaps urethroplasty in 20; two-stage urethroplasty of Johanson procedure in 12; and penile urethra-prostatic urethra anastomosis, three-stage urethroplasty in 2.In early followed up (within 6 months postoperatively), 67 patients (88%) voided well and complications developed in 10. Among the 70 patients who lasted more than 1 year after operation, 51 cases were followed up. Forty-four patients voided well, and complications developed in 8. Of the 8 cases urethral restructure developed in 2 (18%) for pedicle flaps urethroplasty, 2 for colonic mucosal urethroplasty (9%), 1 for buccal mucosal graft (1/7), 1 for bladder mucosal graft (1/3); penile chordee in 2 (2/5), and one of them was accompanied by hair bearing neourethra for two-stage urethroplasty of Johanson procedure.Colonic mucosal and buccal mucosal grafts urethroplasty are feasible procedures for the treatment of long segment urethral stricture, and Colonic mucosal graft urethroplasty may be considered when more conventional procedures fail or complicated urethral strictures greater than 10 cm long.

We investigated the possibility of urethroplasty with a free graft of colonic mucosa for long, complex urethral strictures. We report our initial experience with colonic mucosa graft urethroplasty for such urethral strictures in 16 patients.Between September 2000 and December 2002, 16 patients with a long, complex urethral stricture were treated with colonic mucosal graft urethroplasty. Patients had undergone an average of 2.5 previous unsuccessful repairs. Urethral reconstruction was done with a 10 to 17 cm (median 13) graft of colonic mucosaPatients were followed 6 to 33 months postoperatively. Meatal stenosis that developed in 1 patient 3 months postoperatively needed reoperation. The patient was voiding well with a urinary peak flow of 28.7 ml per second during 9-month followup after reoperation. Hyperplasia of the verumontanum was observed during urethroscopy and transurethral colliculectomy was performed in 1 patient more than 14 months postoperatively. Uroflowmetry showed a urinary peak flow of 46.5 ml per second postoperatively. The other patients were voiding well with a urinary peak flow of greater than 15 ml per second. Urethrogram revealed a patent urethra with an adequate lumen and no significant graft sacculation.This initial experience in 16 patients indicates that colonic mucosa graft urethroplasty is a feasible procedure for long, complex anterior urethral strictures. The technique may be considered for urethral reconstruction when more conventional procedures have failed.

AIM: To investigate the possibility of urethral reconstruction with a free colonic mucosa graft and to present our preliminary experience with urethral substitution using a free graft of colonic mucosa for treatment of 7 patients with complex urethral stricture of a long segment. METHODS: Ten female dogs underwent a procedure in which the urethral mucosa was totally removed and replaced with a free graft of colonic mucosa. A urodynamic study was performed before the operation and sacrifice. The dogs were sacrificed 8 to 16 wk after the operation for histological examination of urethra. Besides, 7 patients with complex urethral stricture of a long segment were treated by urethroplasty with the use of a colonic mucosal graft. The cases had undergone an average of 3 previous unsuccessful repairs. Urethral reconstruction with a free graft of colonic mucosa ranged from 10 to 17 cm (mean 13.1 cm). Follow-up included urethrography, urethroscopy and uroflowmetry. RESULTS: Urethral stricture developed in 1 dog. The results of urodynamic studies showed that the difference in the maximum urethral pressure between the pre-operation and pre-sacrifice in the remaining 9 dogs was not of significance (P > 0.05). Histological examination revealed that the colonic free mucosa survived inside the urethral lumen of the 10 experimental dogs. Plicae surface and unilaminar cylindric epithelium of the colonic mucosa was observed in dogs sacrificed 8 wk after the operation. The plicae surface and unilaminar cylindric epithelium of the colonic mucosa was not observed, and metaplastic transitional epithelium covered a large proportion of the urethral mucosa in dogs sacrificed 12 wk after the operation. Clinically, the patients were followed up for 3-18 mo postoperatively (mean 8.5 mo). Meatal stenosis was developed in 1 patient 3 mo postoperatively and needed reoperation. The patient was voiding very well with urinary peak flow 28.7 mL/s during the follow-up of 9 mo after reoperation. The other patients were voiding well with urinary peak flow greater than 15 mL/s. Urethrogram revealed a patent urethra with an adequate lumen with no significant graft sacculation. Neither necrosis of neourethral mucosa nor stenosis at the anastomosis sites has been observed on urethroscopy in 4 patients over 6 mo after operation. CONCLUSION: Urethral mucosa can be replaced by colonic mucosa without damaging the continence mechanism in female dogs. Colonic mucosa graft urethral substitution is a feasible procedure for the treatment of complex urethral stricture of a long segment. The technique may be considered when more conventional options have failed or are contraindicated.

We constructed a reliable continent tube that is surgically simple.In 12 patients with malignant bladder tumor we performed radical cystectomy with isolation of a 50 cm. ileal loop with pedicle. The proximal segment (8 to 10 cm.) was tapered over a 16Fr catheter as an efferent tube, the remaining segment was detubularized to create a W-shape pouch and the tapered ileum was fixed to the back surface of the rectus muscle with 2 polyester tapers 1 cm. wide with a suspension tension of 500 g. The external orifice of the tapered ileum was anastomosed to the umbilicus. In 2 patients with neuropathic bladder a 15 cm. ileal loop with pedicle was isolated, the proximal segment (8 cm.) was tapered as an efferent tube with 500 g. suspension tension, and the remaining segment was detubularized and anastomosed to the bladder.The patients were followed for 6 to 17 months (mean 11.4) and were completely continent day and night. The stoma was easily catheterized with a 16Fr catheter in all cases. Urodynamic study of the efferent tubes revealed maximum pressure of 84 to 159 cm. water (mean 114). Retrograde radiography of the efferent tubes demonstrated perfect canalization without stenosis.This study suggests that the continent mechanism of the tapered ileum can be greatly enhanced by a suspension technique. This maneuver also provides easy catheterization and surgical simplicity.

To construct a reliable continent tube, which is easy to catheterize and surgically simple.8 adult female mongrel dogs underwent a procedure in which an ileal segment was tapered as an efferent tube. The tapered ileum was fixed to the back surface of the rectus muscle with a polyester taper 1.5 cm in width and a suspension tension of 400 g. The internal orifice of the tapered ileum was anastomosed to the bladder and the external orifice of the tapered ileum was brought out to the abdominal skin. Urodynamic and radiological studies were carried out postoperatively in all dogs.All stomas in dogs could be easily catheterized with a 14-french catheter. Urodynamic study of the efferent tubes showed that the maximum closure pressure ranged from 117 to 157 (mean 136.75) cm water. Retrograde radiogram of the efferent tubes showed perfect canalization without stenosis.This study suggests that the continent mechanism of the tapered ileum can be greatly enhanced by a suspension technique.

OBJECTIVES To develop and report our initial experience with a novel antirefluxing technique for segmental ileal ureteric replacement for the treatment of long ureteric strictures. PATIENTS AND METHODS Between January 2000 and January 2007, 12 cases of ureteric strictures (nine bilateral and three unilateral) were treated using a novel surgical technique in which the ureter was replaced with a segment of ileum using an end-to-side anastomosis. An antireflux valve was constructed by fixing the distal part of upper ureter (4 cm) between the psoas muscle and ileal segment (the ileo-psoas tunnel technique). The distal ileum was connected to the urinary bladder with an end-to-side anastomosis. RESULTS The 12 cases were followed-up for a mean (range) of 39.42 (12-64) months. There were no cases of pyelonephritis or signs of renal failure after surgery. There was dramatic improvement in hydronephrosis, as assessed by intravenous urography, in the 4-9 months after surgery. Cystography showed no evidence of ileo-ureteric reflux. Mild hyperchloraemic acidosis was detected in two patients and was successfully treated with oral alkalization. CONCLUSIONS In our initial experience, ileal ureteric replacement combined with the ileo-psoas tunnel antirefluxing technique is a highly effective procedure for the treatment of ureteric strictures.

The relationship between chronic prostatitis and fertility has been disputed for many years. Several groups have shown infection and autoimmune response against prostate antigens could have a deleterious effect on semen quality and fertility. This study was conducted to test the hypothesis that Omi/HtrA2-induced apoptosis in chronic prostatitis could be a mechanism underlying the observed clinical benefit. The Omi/HtrA2 serine protease is a nuclear-encoded mitochondrial protein, which can be released from mitochondria into the cytosol after apoptosis stimuli, inducing apoptosis in caspase-dependent and independent manners. Forty-one patients diagnosed as suffering from chronic prostatitis were included. Healthy normal individuals were included as controls. Human spermatozoa in the semen were purified by Percoll-gradient technique to separate the seminal plasma and other round cells. Measurements for sperm concentration, motility, morphology, proinflammatory cytokines, Omi/HtrA2 mRNA and protein levels in spermatozoa of chronic protatitis patients, were performed accordingly. Significantly increased levels of proinflammatory cytokines were detected in seminal plasma from these prostatitis patients. Omi/HtrA2 mRNA and protein levels were significantly higher in prostatitis men than in normal men. This study shows that chronic prostatitis patients present important alterations in their semen quality parameters, Omi/HtrA2 mRNA and protein levels of spermatozoa. We speculate that the inflammatory process involved may affect male fertility by release of proapoptotic protein Omi/HtrA2.