Objective To investigate the feasibil ity of replacing urinary epithel ial cells with oral mucosa cell to reconstruct tissue engineered urethra by being seeded on bladder acellular matrix graft (BAMG). Methods Eighteen male New Zealand rabbits, aged 10 weeks, weighing 0.3-0.5 kg, were used in this study. Oral mucosa cell of 12 rabbits were isolated and seeded onto a culture dish with a feeder layer of 3T3 and a culture dish without 3T3, respectively. The morphologic change and growth condition of oral mucosa cells were observed by inverted phase contrast microscope after 2 days of seeding. The quantity of oral mucosa cells was counted using cell counting meter; the cell growth curve was drawn and the immunofluorescence staining with broad-spectrum keratin antibody was carried out. The bladders taken from the rest 6 rabbits were decelluled to make BAMG and the tissue of 1 cm × 1 cm was randomly selected to observe the effect of acellularization. The second passage oral mucosa cells cultured with 3T3 were appl ied to steril ized BAMG to obtain a issueengineered mucosa. The tissue-engineered mucosa was assessed using HE staining and scanning electron microscope after being cultured for 1 week. Results Oral mucosa cells seeded onto a feeder layer of 3T3 could be passaged for 7 or 8 generations with homogeneous forms and full function. Oral mucosa cells cultured without 3T3 could only be subcultured for 2 generations before aging and had multiple shapes and different sizes. Oral mucosa cells cultured by the two methods both started logarithmic growth on the 8th day and reached the peak value on the 14th day, which was indicated by the cell growth curve. However, more cells could be obtained through oral mucosa cells cultured with 3T3 than those cultured without 3T3. Oral mucosa cells manifestated green colour fluorescence cultured with or without 3T3. After the cells were removed, the BAMG presented as a porous membrane. The HE staining showed that the effect of acellularization was good and there were no cells at BAMG. The second passage oral mucosa cells cultured with 3T3 were expanded and seeded onto steril ized BAMG to obtain a tissue-engineered mucosa. Good compatibil ity of the compound graft was assessed using HE staining and scanning electron microscope. HE staining and scanning electron microscope showed that oral mucosa cells had good biocompatibil ity with BAMG after the tissue engineered mucosa was cultured for 1 week. Conclusion Oral mucosa cells of rabbit can be cultured in vitro and attain magnitude quantities. Oral mucosa cell also have good biocompatibil ity with BAMG and the compound graft could be a new material for urethral reconstruction.
ObjectiveTo explore the effect of clinical nursing pathway on rehabilitation indicators in patients who had undergone transurethral resection of prostate (TURP). MethodsA total of 241 patients underwent TURP between July 2010 and March 2014 were randomly divided into path group (121 cases) and control group (120 cases). The nursing results of the two groups were observed. ResultsThe complication rate of bladder spasm, secondary hemorrhage, urethral stricture in path group were lower than those in the control group with significant differences (P<0.05). ConclusionThe performance of clinical nursing pathway on TURP patients may reduce the complications rate, and promote the health economics indicators and quality of care.
Objective To investigate the feasibil ity of prefabricating urethra in the expander capsule with gelatin sponge and micro-mucosa compound transplantation. Methods Eight 8-week-old Guizhou miniature pigs (male and/or female) weighing 20-25 kg were used. Six expanders (15 mL) were placed subcutaneously on the dorsal thorax of each miniaturepig. Autologous oral mucosa of every pig was harvested 2 weeks later to prepare micro-mucosa with a diameter less than 1 mm. Gelatin sponge 3 cm × 2 cm in size was transplanted to the expander capsule after being coated by the autologous micromucosa at the area expansion ratio of 4 ∶ 1 (group A), 8 ∶ 1 (group B), and 16 ∶ 1 (group C), respectively (n=2 per group). The implantation of gelatin sponge served as the blank control (group D, n=2). Physiological sal ine was injected into the expander immediately after operation, and the pressure in the expander was 40 mm Hg (1 mm Hg=0.133 kPa). The postoperative general condition of the animals was observed. At 1, 2, and 3 weeks after operation, the animals were killed to receive general, HE staining, and immunohistochemistry staining observations. Results All animals survived till the end of the experiment. The wounds healed well. General observation: in groups A, B, and C at 1 week after operation, there was no obvious degeneration of gelatin, the mucous was survived partially, and there were significant differences among three groups in terms of mucosa healing rate (P lt; 0.05), groups A and B were better than group C, and group A was better than group B; at 2 weeks, the gelatin sponge was partly absorbed, most of the mucosa survived, and the mucosa healing rate of groups A and B was better than that of group C (P lt; 0.05); at 3 weeks, the gelatin sponge was still not absorbed completely, the wound reached epithel ial ization approximately,and there were no significant differences among three groups in terms of mucosa heal ing rate (P gt; 0.05). No neo-mucosa was evident in group D at each time point. Histology and immunohistochemistry staining observation: at each time point, the mucosa epithel ium survival, inflammatory cell infiltration, and pan-cytokeratin were evident in groups A, B, and C; at 3 weeks after operation, the stratified squamous epithel ium presented obvious polarity and the submucous neovascularization was abundant in groups A, B, and C. There was no mucosa epithelium and positive stained pan-cytokeratin in group D. For the percentage of positive pan-cytokeratin stained area, there were significant differences among groups A, B, and C 1 week after operation (P lt; 0.05); at 2 and 3 weeks after operation, there was significant difference between group A and group C, and between group B and group C (P lt; 0.05); but no significant difference was evident between group A and group B (P gt; 0.05). Conclusion Micro-mucosa and gelatin spongy compound transplantation on the expander capsule can form mucosal l ining, achieve complete epithel ial ization in 2 weeks, and contribute to maintain the normal function of prefabricatied urethra.
ObjectiveTo evaluate the effect of postoperative no indwelling urethral catheters in lung operation. MethodsIn this prospective cohort study, we recruited 100 patients who were scheduled for pulmonary lobectomy under general anesthesia in a single institution of Thoracic Surgery Department in West China Hospital between April and December 2014. These patients were divided into two groups including a no indwelled urethral catheter group (NIUC, 50 patients) and an indwelled urethral catheter group (IUC, 50 patients). The clinical effect was compared between the two groups. ResultsThere was no statistical difference in incidence of postoperative urinary retention or urinary tract infection between the two groups (P=0.433, 0.050). However, the comfort degrees(0 degree) of patients in the NICU group was significantly higher than that of the ICU group with a statistical difference (P=0.002). While postoperative hospitalization time in the NICU group (P=0.023) was shorter than that in the ICU group (P=0.004). Prostatic hyperplasia was the high risk factor for the lung postoperative urinary retention (P=0.056). ConclusionPostoperative no indwelling urethral catheters in lung operation has the benefit of improving the comfort degrees of inpatients and increasing the postoperation urinary retention.
One-hundred and thirty cases of hymenosis of female urethral orifice with anomalies from May, 1985 through October, 1990 were studied. The patients all received plastic reconstruction of the urethral orifice, and have been followed up for 3 months to 6 years with a cure and improvement rate of 92.1 percent. This anomaly is one of the important causes causing infection of the lower urinary tract. The mechanism of the pathology and the principles of treatment were discussed.
摘要:目的: 观察腰硬联合麻醉在前列腺电切术患者中的临床应用效果。 方法 : 76例经尿道前列腺电切术患者(78±7岁)随机均分为腰硬联合麻醉组(C组)及硬膜外组(E组)。C组以腰硬联合穿刺针于L34穿刺至蛛网膜下腔后,注入05%布比卡因2 mL,通过硬膜外穿刺针置入硬膜外导管;E组行L34间隙硬膜外穿刺置管。记录麻醉起效时间、麻醉效果、麻醉前及麻醉后5、15、30分钟时血压、心率。 结果 : 所有患者均穿刺顺利,麻醉起效时间C组为36±13 min, E组68±15 min;C组麻醉效果完善率为100%,E组为95%;麻醉后两组血压均下降(〖WTBX〗P lt;005),但降幅均未超过基础值的20%;两组麻醉前及麻醉后血压、心率均无显著性差异。 结论 :腰硬联合麻醉用于前列腺电切术具有起效快、麻醉效果佳的优点。Abstract: Objective: To investigate and compare the clinical efficacy and safety of combined spinalepidural(CSEA) and epidural(EA) anesthesia on elderly patients undergoing transurethral resection of the prostate(TURP). Methods : 76 patients(78±7 years) suffering TURP were divided into two group: group CSEA(38cases) and groupEA(38 cases). The dose of bupivacaine in spinal anesthesia is 10 mg. Blood pressure(BP), heart rate(HR) and anesthesia efficacy were observed before anesthesia, 5, 15 and 30min after anesthesia. Results : BP decreased after anesthesia in two groups than before anesthesia(〖WTBX〗P lt;005). The decreases of BP were less than 20% of basises. There were no significant differents of BP and HR between two groups before and after anesthesia. Conclusion :CSEA with bupivacaine 10 mg is safe and efficient in elderly undergoing TURP.
Objective To assess the efficacy of finasteride in treating perioperative bleeding in patients undergoing transurethral resection of the prostate (TURP). Methods We searched MEDLINE (1966 to 2005), EMBase (1984 to 2004), CBM (1980 to 2005), The Cochrane Library (Issue 4, 2005) and relevant journals to identify cl inical trials involving finasteride in patients undergoing TURP. We also checked the references in the reports of each included trial. The qual ity of randomized controlled trials (RCTs) was assessed according to the methods recommended by The Cochrane Collaboration, and the qual ity of non-RCTs was assessed based on the methods recommended by Jiang-ping Liu, Stroup and Hailey. Two reviewers extracted data independently and data analyses were conducted with The Cochrane Collaboration’ s RevMan 4.2. Result We included 4 RCTs and 1 non-RCT. The qual ity of 3 RCTs was graded C and the other one was graded B. The quality of the non-RCT was relatively high. Meta-analyses showed that with comparable age, international prostate symptom score, prostate specific antigen, preoperative volume of prostate and excision volume between the two groups (Pgt;0.05), the perioperative bleeding volume (WMD –85.44, 95%CI –117.31 to –53.58), the bleeding volume per gram of resected prostate tissue (WMD –3.5, 95%CI –6.34 to –0.58) and hemoglobin reduction (WMD –1.61, 95%CI –1.96 to –1.26) of the finasteride group were significantly smaller than those of the control group. Conclusion The evidence currently available indicates that preoperative use of finasteride may reduce bleeding in patients undergoing TURP.
Objective To evaluate the clinical effect of balloon dilatation in the treatment of lower urinary tract obstruction in children. Methods Twenty-six boys suffering from lower urinary tract obstruction underwent the balloon dilatation operation. These patients included 23 cases of posterior urethral valves, 2 cases of anterior urethral valves and 1 case of traumatic urinary tract stricture. Their ages ranged from 18 days to 7 years. All the patients were diagnosed by voiding cystourethrogram (VCG). Some of the boys suffered from bilateral hydronephrosis and dilated ureters. Before operation, the patients with urine retention or abnormal renal function should drain urine and correct the disorderof fluid and electrolyte. Balloon dilatation was done after their conditions were improved. During operation, ketamine anaesthesia was used, and 30% diatrizoate melglumine was used as dilatation drug. The balloon catheters which had the length of 4 cm and the diameters of 5，8，10 mm respectively were used for dilating the urethra. After operation, a Foley’s catheter was routinely indwelled. Results During procedure, compression phenomena disappeared in the course of operation. All the patients urinated normally after catheter was removed at 1 week post operatively. 6 cases received ureteral reimplantation to prevent vesioureteral reflux after 1 to 3 months. 25patients were followed up from 1 to 13 years and all patients had normal micturition and the bilateral hydronephrosis were improved. Conclusion Balloon dilatation is a safe, effective and feasible therapy for lower urinary tract obstruction in children.
Objective To evaluate the efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with transurethral resection of bladder tumor (TURBT) for muscle-invasive bladder cancer (MIBC). Methods China National Knowledge Infrastructure, Chongqing VIP, Wanfang, SinoMed, PubMed, Web of Science, and Cochrane Library were searched from the establishment of databases until December 2023. All randomized controlled trials of TACE combined with TURBT for MIBC were collected and subjected to meta-analysis using RevMan 5.4 software. Results A total of 7 studies were included, involving 490 patients, with 246 in the TACE+TURBT group and 244 in the TURBT group. The meta-analysis results showed that compared with TURBT, TACE+TURBT had certain advantages in reducing recurrence rate [relative risk (RR)=0.49, 95% confidence interval (CI) (0.35, 0.68)], improving survival rate [RR=1.16, 95%CI (1.07, 1.27)], shortening surgical time [standardized mean difference (SMD)=−4.97, 95%CI (−7.54, −2.40)], reducing intraoperative bleeding [SMD=−4.19, 95%CI (−5.78, −2.60)], and improving quality of life [SMD=4.51, 95%CI (2.15, 6.86)]. The adverse reactions of the two groups were similar. Conclusions Existing evidence suggests that TACE may reduce intraoperative bleeding and shorten surgical time to help achieve maximum TURBT. TACE combined with TURBT may be superior to simple TURBT in terms of tumor recurrence rate and survival rate. TACE combined with TURBT can benefit MIBC patients in bladder-preserving treatment plans.