Polymorphonuclear (PMN) cell count in the ascitic fluid is essential for the diagnosis and management of spontaneous bacterial peritonitis (SBP). To date, PMN cell count is routinely performed by traditional manual co...Polymorphonuclear (PMN) cell count in the ascitic fluid is essential for the diagnosis and management of spontaneous bacterial peritonitis (SBP). To date, PMN cell count is routinely performed by traditional manual counting. However, this method is time-consuming, costly, and not always timely available. Therefore, considerable efforts have been made in recent years to develop an alternative test for a more rapid diagnosis and monitoring of SBP. The use of urinary reagent strips was proposed to achieve an "instant" bedside diagnosis of SBP. A series of reports evaluated the urine strip test for SBP diagnosis and reported promising results. However, a recent large multicenter study revealed a surprising lack of diagnostic effi cacy of the urine screening test for SBP diagnosis. Another method, more recently proposed as an alternative to the manual PMN count, is the measurement of lactoferrin in ascitic fluid, but the data available on the diagnostic value of this test are limited to a single study. However, both urinary reagent strips and ascitic lactoferrin tests are qualitative methods and need, therefore, to be further confirmed by standard cytology of the ascitic fluid. To date, the only quantitative method proposed as a valid alternative to manual PMN counting is automated blood cell counters, commonly used in all laboratories for blood cell counting. Data available in the literature on the diagnostic performance of this method are limited but very promising, and this tool seems to have the potential to replace the manual counting method.展开更多
Objective To investigate oxidative DNA damage in pharmacy technicians preparing antineoplastic drugs at the PIVAS （Pharmacy Intravenous Admixture Service） in two Chinese hospitals. Methods Urinary 8-OHdG served as a...Objective To investigate oxidative DNA damage in pharmacy technicians preparing antineoplastic drugs at the PIVAS （Pharmacy Intravenous Admixture Service） in two Chinese hospitals. Methods Urinary 8-OHdG served as a biomarker. 5-Fluorouracil （5-FU） concentrations in air, masks and gloves were determined. The spill exposure of each PIVAS technician to antineoplastic drugs was investigated. Eighty subjects were divided into exposed group t, II, and control group I, II. Results 5-FU concentration ratios for gloves and masks in exposed group I were significantly higher than those in exposed group II （P〈0.05 or P〈0.01）. The average urinary 8-OHdG concentrations in exposed group I, control group I, exposed group II, and control group II were 24.69＋0.93, 20.68＋1.07, 20.57＋0.55, and 12.96_＋0.73 ng/mg Cr, respectively. Urinary 8-OHdG concentration in exposed group I was significantly higher than that in control group I or that in exposed group 11 （P〈0.02）. There was a significant correlation between urinary 8-OHdG concentrations and spill frequencies per technician （P〈0.01）. Conclusion There was detectable oxidative DNA damage in PIVAS technicians exposed to antineoplastic drugs. This oxidative DNA damage may be associated with their spill exposure experience and contamination of their personal protective equipment.展开更多
BACKGROUND: Urinary trypsin inhibitor (UTI) inhibits the inflammatory response and protects against ischemia-reperfusion (I/R) injury. The inflammatory response is mediated by nuclear factor-kappa B (NF-kappa B) and i...BACKGROUND: Urinary trypsin inhibitor (UTI) inhibits the inflammatory response and protects against ischemia-reperfusion (I/R) injury. The inflammatory response is mediated by nuclear factor-kappa B (NF-kappa B) and its related target genes and products such as vascular endothelial cell adhesion molecule and CXC chemokines. We aimed to assess the roles of those mediators in a UTI-treated mouse model of hepatic I/R injury. METHODS: Treatment group 1 (UTI given 5 minutes prior to liver ischemia), treatment group 2 (UTI given 5 minutes after the anhepatic phase) and a control group were investigated. Blood and liver samples were obtained and compared at 1, 3, 6 and 24 hours after reperfusion. RESULTS: Attenuation of pathological hepatocellular damage was greater in the treatment groups than in the control group (P < 0.05). Compared with the control group, the UTI treatment groups showed significantly lower serum alanine aminotransferase and aspartate aminotransferase levels, decreased myeloperoxidase activity, and reduced NF-kappa B activation. Also downregulated was the expression of tumor necrosis factor-alpha, cytokine-induced neutrophil chemoattractant, and macrophage inflammatory protein-2 at the mRNA level. P-selectin protein and intercellular adhesion molecule-1 protein expression were also downregulated. In addition, the treatment group I showed a better protective effect against I/R injury than the treatment group 2. CONCLUSIONS: UTI reduces NF-kappa B activation and downregulates the expression of its related mediators, followed by the inhibition of neutrophil aggregation and infiltration in hepatic I/R injury. The protective role of UTI is more effective in prevention than in treatment.展开更多
Background We randomly sampled a healthy community to evaluate the prevalence and associated risk factors of urinary incontinence. Methods The survey was performed in Fuzhou, China. Of women over twenty years of age i...Background We randomly sampled a healthy community to evaluate the prevalence and associated risk factors of urinary incontinence. Methods The survey was performed in Fuzhou, China. Of women over twenty years of age in the city, 3.0% were randomly selected and 4684 evaluated by Bristol Female Urinary Tract Symptoms Questionnaire. Results Of the women in Fuzhou, 19.0% had urinary incontinence. The prevalence of stress incontinence, urge incontinence and mixed incontinence was 16.6% (n=777), 10.0% (n=468), 7.7% (n=360) respectively. The prevalence of the three types of urinary incontinence increased significantly with age (P<0.01). In multiple logistic models, age (OR, 1.3, 95%CI, 1.1-1.4), vaginal delivery (3.0, 1.9-4.7), parity >2 (2.1, 1.5-2.9), hypertension (2.7, 1.4-5.6), constipation (2.6, 1.8-3.8), alcohol consumption (4.7, 1.1-20.2), episiotomy (1.7, 1.4-2.0), higher body mass index (BMI, 1.8, 1.5-2.2) and unskilled worker (0.7, 0.5-0.8) were potential risk factors for stress incontinence. Urge incontinence was associated with age (OR, 1.3, 95%CI, 0.9-1.3), menopause (1.6, 1.1-2.4), Caesarean delivery (0.2, 0.1-0.5), parity >2 (2.6, 1.8-3.8), constipation (2.3, 1.4-3.7), foetal birthweight (1.7, 1.1-2.4), episiotomy (1.4, 1.1-1.8), higher BMI (1.5, 1.2-2.0) and unskilled worker (0.7, 0.5-0.9). Conclusions The prevalence of urinary incontinence and its subtypes in Chinese women is lower than that of occidental women. In China, age, vaginal delivery, parity, hypertension, constipation, alcohol consumption, episiotomy, higher BMI are potential risk factors for stress incontinence. Urge incontinence is associated with age, menopause, Caesarean delivery, parity, constipation, foetal birthweight, episiotomy, higher body mass index.展开更多
Small vessel disease （SVD） is responsible for brain chronic circular disorder,and accounts for 20%–30%cases of ischemic stroke as well as cerebral hemorrhage,and to a great extent,encephalopathy.Binswanger’s disea...Small vessel disease （SVD） is responsible for brain chronic circular disorder,and accounts for 20%–30%cases of ischemic stroke as well as cerebral hemorrhage,and to a great extent,encephalopathy.Binswanger’s disease and multiple small strokes,which are common in older people,are also closely associated with SVD.These disorders often cause decline in cognition,vascular dementia,impairment in gait and balance,mood depression,and urinary incontinence,and often brings great social and economic burdens.SVD-related encephalopathy increases the incidences of fall,disability and death in elderly people.With the aging of the society,more attention should be paid to the importance of early diagnosis and prophylactic treatment of SVD.Here the clinical manifestations and pathophysiology of SVD are reviewed.展开更多
Summary: In order to study the association between lower urinary tract infection and cystitis glandularis (CG), 120 cases of CG were diagnosed by cystoscopic biopsy in the suspicious foci of the bladder. Among them, 7...Summary: In order to study the association between lower urinary tract infection and cystitis glandularis (CG), 120 cases of CG were diagnosed by cystoscopic biopsy in the suspicious foci of the bladder. Among them, 72 cases were subjected to bacterial counting culture of urine and microscopic examination of urinary sediment, and 60 cases to fluorescence quantitative polymerase chain reaction (FQ-PCR) assay to detect HPV, CMV and HSV DNA in urine samples. In the 72 cases of CG, the positive rate of bacterial counting culture of urine was 15.3 % (11/72), and gray zone rate was 18.1 % (13/72). 31.9 % (23/72) patients were positive in bacterioscopy of urinary sediment. There was statistically significant difference as compared with the control group (P<0.01). Only 4 of 60 urine samples were positive by FQ-PCR in detection of the three viruses mentioned above with the positive rate being 6.67 %. Compared with the control group, there was no significant difference (P>0.05). It was concluded that the genesis of CG was closely correlated with the chronic lower urinary tract infection, especially caused by Esch coli.展开更多
AIM To report the results of the International Nosocomial Infection Control Consortium(INICC) study conducted in Quito, Ecuador.METHODS A device-associated healthcare-acquired infection(DAHAI) prospective surveillance...AIM To report the results of the International Nosocomial Infection Control Consortium(INICC) study conducted in Quito, Ecuador.METHODS A device-associated healthcare-acquired infection(DAHAI) prospective surveillance study conducted from October 2013 to January 2015 in 2 adult intensive care units(ICUs) from 2 hospitals using the United States Centers for Disease Control/National Healthcare Safety Network(CDC/NHSN) definitions and INICC methods. RESULTS We followed 776 ICU patients for 4818 bed-days. The central line-associated bloodstream infection(CLABSI) rate was 6.5 per 1000 central line(CL)-days, the ventilator-associated pneumonia(VAP) rate was 44.3 per 1000 mechanical ventilator(MV)-days, and the catheterassociated urinary tract infection(CAUTI) rate was 5.7 per 1000 urinary catheter(UC)-days. CLABSI and CAUTI rates in our ICUs were similar to INICC rates [4.9(CLABSI) and 5.3(CAUTI)] and higher than NHSN rates [0.8(CLABSI) and 1.3(CAUTI)]- although device use ratios for CL and UC were higher than INICC and CDC/NSHN's ratios. By contrast, despite the VAP rate was higher than INICC(16.5) and NHSN's rates(1.1), MV DUR was lower in our ICUs. Resistance of A. baumannii to imipenem and meropenem was 75.0%, and of Pseudomonas aeruginosa to ciprofloxacin and piperacillin-tazobactam was higher than 72.7%, all them higher than CDC/NHSN rates. Excess length of stay was 7.4 d for patients with CLABSI, 4.8 for patients with VAP and 9.2 for patients CAUTI. Excess crude mortality in ICUs was 30.9% for CLABSI, 14.5% for VAP and 17.6% for CAUTI. CONCLUSION DA-HAI rates in our ICUs from Ecuador are higher than United States CDC/NSHN rates and similar to INICC international rates.展开更多
Background The composition of the lung preservation solution used in lung graft procurement has been considered the key to minimize lung injury during the period of ischemia. Low-potassium dextran glucose （LPDG）, an...Background The composition of the lung preservation solution used in lung graft procurement has been considered the key to minimize lung injury during the period of ischemia. Low-potassium dextran glucose （LPDG）, an extracellular-type solution, has been adopted by most lung transplantation centers, due to the experimental and clinical evidences that LPDG is superior to intracellular-type solutions. Ulinastatin has been shown to attenuate ischemia-reperfusion （I/R） injury in various organs in animals. We supposed that the addition of ulinastatin to LPDG as a flushing solution, would further ameliorate I/R lung injury than LPDG solution alone.Methods Twelve male New Zealand white rabbits were randomly divided into 2 groups. Using an alternative in situ lung I/R model, the left lung in the control group was supplied and preserved with LPDG solution for 120 minutes. In the study group 50 000 U/kg of ulinastatin was added to the LPDG solution for lung preservation. Then re-ventilation and reperfusion of the left lung were performed for 90 minutes. Blood gas analysis （PaO2, PaCO2）, mean pulmonary artery pressure （MPAP） and serum TNF-α level were measured intermittently. The pulmonary water index （D/W）, tissue myeloperoxidase （MPO） activity, tissue malondialdehyde （MDA） content and morphologic changes were analyzed.Results The study group showed significantly higher PaO2 and lower MPAP at the end of reperfusion. Serum TNF-α level, left lung tissue MPO and MDA in the study group were significantly lower than those in the control group. D/W and pathologic evaluation were also remarkably different between the two groups.Conclusions This study indicated that better lung preservation could be achieved with the use of an ulinastatin modified LPDG solution. Ulinastatin further attenuated lung I/R injury, at least partly by reducing oxidative reactions,inhibiting the release of inflammatory factors and neutrophils immigration.展开更多
AIM: To assess the usefulness of urinary trypsinogen-2 test strip, urinary trypsinogen activation peptide (TAP),and serum and urine concentrations of the activation peptide of carboxypeptidase B (CAPAP) in the diagnos...AIM: To assess the usefulness of urinary trypsinogen-2 test strip, urinary trypsinogen activation peptide (TAP),and serum and urine concentrations of the activation peptide of carboxypeptidase B (CAPAP) in the diagnosisof acute pancreatitis.METHODS: Patients with acute abdominal pain and hospitalized within 24 h after the onset of symptoms were prospectively studied. Urinary trypsinogen-2 was considered positive when a clear blue line was observed (detection limit 50 μg/L). Urinary TAP was measured using a quantitative solid-phase ELISA, and serum and urinary CAPAP by a radioimmunoassay method.RESULTS: Acute abdominal pain was due to acute pancreatitis in 50 patients and turned out to be extrapancreatic in origin in 22 patients. Patients with acute pancreatitis showed significantly higher median levels of serum and urinary CAPAP levels, as well as amylase and lipase than extrapancreatic controls. Median TAP levels were similar in both groups. The urinary trypsinogen-2 test strip was positive in 68% of patients with acute pancreatitis and 13.6% in extrapancreatic controls (P<0.01). Urinary CAPAP was the most reliable test for the diagnosis of acute pancreatitis (sensitivity 66.7%, specificity 95.5%, positive and negative predictive values 96.6% and 56.7%, respectively), with a 14.6 positive likelihood ratio for a cut-off value of 2.32 nmol/L.CONCLUSION: In patients with acute abdominal pain,hospitalized within 24 h of symptom onset, CAPAP in serum and urine was a reliable diagnostic marker of acute pancreatitis. Urinary trypsinogen-2 test strip showed a clinical value similar to amylase and lipase.Urinary TAP was not a useful screening test for the diagnosis of acute pancreatitis.展开更多
Objective:Percutaneous nephrolithotomy(PCNL)is commonly used in the management of large renal stones.Postoperative infections are one of the most common complications of this procedure.The present study is to determin...Objective:Percutaneous nephrolithotomy(PCNL)is commonly used in the management of large renal stones.Postoperative infections are one of the most common complications of this procedure.The present study is to determine and assess the factors that may increase the risk to develop fever and urinary sepsis after PCNL.Methods:A total of 60 patients(38 males and 22 females)with a mean age of 40.25 years enrolled in this study in Sulaimania Teaching Hospital.Patients had renal stone disease need operation with different socioeconomic status,body mass index and different type and size of stones were included in this study.Patients with preoperative positive urine culture and sensitivity were excluded.Preoperative investigations done for all patients.All Patients received prophylactic antibiotic gentamicin intravenously at the induction of anaesthesia.Renal pelvis urine sample were taken from all patients after puncturing the pelvicalyceal system and send for culture and sensitivity.Patients were monitored closely in the postoperative period for the development of fever and sepsis.Results:Mean duration of the operations was 77.08 min ranged 40e120 min.All patients had postoperative nephrostomy tube.Seventeen(28.33%)patients developed post PCNL fever and the statistically significant factors for post PCNL fever were diabetes mellitus(DM)(p Z 0.001),stone burden(p Z 0.001),number of the stones(p<0.001),degree of hydronephrosis(p Z 0.001),duration of the operation(p<0.001),residual stones(p Z 0.001)and number of tracts(p Z 0.038).Three(5.00%)patients developed post PCNL sepsis,and the statistically significant risk factors for post PCNL sepsis were duration of the operation(p Z 0.013)and intraoperative blood loss,postoperative drop in haemoglobin(HB)level(p Z 0.046).Conclusion:DM,staghorn stones,degree of hydronephrosis,duration of the operation and number of tracts are risk factors for post PCNL fever,while number of stones,intraoperative blood loss,duration of the operation and residual stones are risk factors for post PC展开更多
The emergence of antibiotic resistant bacteria in the healthcare is a serious concern.In the Healthcare premises precisely intensive care unit are major sources of microbial diversity.Recent findings have demonstrated...The emergence of antibiotic resistant bacteria in the healthcare is a serious concern.In the Healthcare premises precisely intensive care unit are major sources of microbial diversity.Recent findings have demonstrated not only microbial diversity but also drug resistant microbes largely habitat in ICU.Pseudomonas aeruginosa found as a part of normal intestinal flora and a significant pathogen responsible for wide range of ICU acquired infection in critically ill patients.Nosocomial infection associated with this organism including gastrointestinal infection,urinary tract infections and blood stream infection.Infection caused by this organism are difficult to treat because of the presence of its innate resistance to many antibiotics(b-lactam and penem group of antibiotics),and its ability to acquire further resistance mechanism to multiple class of antibiotics,including Beta-lactams,aminoglycosides and fluoroquinolones.In the molecular evolution microbes adopted several mechanism to maintain genomic plasticity.The tool microbe use for its survival is mainly biofilm formation,quorum sensing,and horizontal gene transfer and enzyme promiscuity.Such genomic plasticity provide an ideal habitat to grow and survive in hearse environment mainly antibiotics pressure.This review focus on infection caused by Pseudomonas aeruginosa,its mechanisms of resistance and available treatment options.The present study provides a systemic review on major source of Pseudomonas aeruginosa in ICU.Further,study also emphasizes virulence gene/s associated with Pseudomonas aeruginosa genome for extended drug resistance.Study gives detailed overview of antibiotic drug resistance mechanism.展开更多
To evaluate the efficacy and safety of plasmakinetic resection of the prostate （PKRP） versus transurethral resection of the prostate （TURP） for the treatment of patients with benign prostate hyperplasia （BPH）, a...To evaluate the efficacy and safety of plasmakinetic resection of the prostate （PKRP） versus transurethral resection of the prostate （TURP） for the treatment of patients with benign prostate hyperplasia （BPH）, a meta-analysis of randomized controlled trials was carried out. We searched PubMed, Embase, Web of Science and the Cochrane Library. The pooled estimates of maximum flow rate, International Prostate Symptom Score, operation time, catheterization time, irrigated volume, hospital stay, transurethral resection syndrome, transfusion, clot retention, urinary retention and urinary stricture were assessed. There was no notable difference in International Prostate Symptom Score between TURP and PKRP groups during the 1-month, 3 months, 6 months and 12 months follow-up period, while the pooled Qmax at 1-month favored PKRP group. PKRP group was related to a lower risk rate of transurethral resection syndrome, transfusion and clot retention, and the catheterization time and operation time were also shorter than that of TURP. The irrigated volume, length of hospital stay, urinary retention and urinary stricture rate were similar between groups. In conclusion, our study suggests that the PKRP is a reliable minimal invasive technique and may anticipatoriiy prove to be an alternative electrosurgical procedure for the treatment of BPH.展开更多
Background Dysregulation of apoptosis has been implicated not only in carcinogenesis and tumor progression but also in tumor recurrence. We investigated whether the expression of X-linked inhibitor of apoptosis （XIAP...Background Dysregulation of apoptosis has been implicated not only in carcinogenesis and tumor progression but also in tumor recurrence. We investigated whether the expression of X-linked inhibitor of apoptosis （XIAP） might predict early recurrence in patients with non-muscular invasive bladder cancer. Methods The cohort comprised 176 consecutive patients with primary superficial bladder cancer treated with transurethral resection. Immunohistochemical staining using the standard avidin-bioUn-peroxidase technique and RT-PCR were used to detect XIAP protein and mRNA expressions in cancer tissues. The relationship between XIAP expression and clinicopathological characteristics, cancer recurrence were analyzed. Results XIAP expression was observed in 108 cases （61.4%） and no expression in 68. There was no correlation between XIAP expression rate and the tumor pathological grade, but was an apparent trend toward the increased XIAP levels from well （G1） to poor （G3） differentiated cancer. Eighty-two （46.6%） patients experienced tumor recurrence at a mean of 28.6 months of the follow-up; 66 of them expressed XIAP （61.1%） and 16 were XIAP negative （23.5%）. Twelve patients presented with invasive disease at the time of relapse and all of them expressed XIAP. Patients without XIAP expression or with low tumor grades had significantly higher recurrence-free survival than those with XIAP expression （log rank test ,P=-0.0015） or high tumor grades （log rank test P〈0.001）. Multivariate analysis revealed that XIAP expression, tumor grade, and tumor number were independent predictors for the recurrence of non-muscular invasive bladder cancer （P=-0.004, 0.016, and 0.043, respectively）. Conclusions XIAP may be considered as a new independent prognostic marker for early recurrence of non-muscular invasive bladder cancer.展开更多
Background Traumatic damage to fascial and muscular support structures during childbirth may be a major factor of the development of stress urinary incontinence （SUI） and pelvic organ prolapse （POP）. The aim of th...Background Traumatic damage to fascial and muscular support structures during childbirth may be a major factor of the development of stress urinary incontinence （SUI） and pelvic organ prolapse （POP）. The aim of this study was to prospectively investigate the role of different childbirth strategies on POP and SUI. Methods A total of 120 selected pregnant women were recruited and divided into two groups： vaginal delivery group （n=72） and selective cesarean delivery group （n=48）. The women were questioned with SUI sheet and estimated with POP quantification （POP-Q） within 6-8 weeks after delivery. The correlations of SUI and results of POP-Q with the strategies of delivery were analyzed, ttest, X2 test, and the Mann-Witney test were used for statistical analysis. Results Among the 120 women, SUI was developed during 29-30 gestational weeks in 20 patients （16.6%）, of whom 14 （70%） had symptoms of SUI till 6 weeks postpartum. Totally 20 （16.6%） women had SUI symptoms after delivery. The prevalence of postpartum SUI was positively correlated with the occurrence of SUI during 29-30 gestational weeks （P〈0.001）. In the vaginal delivery group, 100% of the women suffered form urinary prolapse 6 weeks postpartum, while 87.5% of those in the selective cesarean delivery group developed POP （P〈0.01）. The percentages of the first- and second-degree urinary prolapse in the vaginal delivery group were 20.8% and 79.2% respectively, which were significantly different from those in the selective cesarean delivery group （64.6% and 22.9%; both P=0.000）. Conclusions Pregnancy and delivery play an etiologic role in the development of SUI and POP. The onset of SUI during late pregnancy implies a significant risk of postpartum SUI symptoms. The prevalence of POP is significantly higher after vaginal delivery than after cesarean delivery.展开更多
In this study, we examined the relationship between sex hormone levels and lower urinary tract symptoms （LUTS） in men with benign prostatic hyperplasia （BPH） who underwent transurethral surgery. The study was cond...In this study, we examined the relationship between sex hormone levels and lower urinary tract symptoms （LUTS） in men with benign prostatic hyperplasia （BPH） who underwent transurethral surgery. The study was conducted in 158 patients who came to our hospital for surgery. Clinical conditions were assessed by body mass index （BMI）, digital rectal examination, International Prostate Symptom Score （IPSS） and transrectal ultrasound （TRUS）. The levels of sex hormones （including total testosterone （TT）, estradiol （E2）, progesterone （P）, luteinizing hormone （LH）, follicle-stimulating hormone （FSH） and prolactin （PRL）） and prostate-specific antigen （PSA） were reviewed. Correlations were determined through statistical analysis. The mean age was 72.06 _＋ 8.68 years. The total IPSS was significantly associated with the TT level （r = -0.21, P = 0.01）. Other sex hormone levels were not correlated with total IPSS. However, some ratios such as E2/TT （r = 0.23, P = 0o00） and FSH/LH （r = -0.17, P = 0.04） were associated with total IPSS. Further analysis showed that the nocturia was associated with age （r = 0.16, P = 0.04）, BMI （r = 0.21, P = 0.01）, and TT （r = -0.19, P = 0.02）. Moreover, we divided the patients into two subgroups based on IPSS severity （〈20 or 〉20）. The mean TT level was in the normal range, but it was significantly related to the presence of severe LUTS. In summary, our study has shown that the severity of LUTS is associated with TT, EJTT and FSH/LH in men who underwent prostate surgery. Increasing nocturia was observed in lower testosterone patients. Additional larger studies are needed to elucidate the potential mechanisms.展开更多
Objective:To examine the relationship between benign prostatic hyperplasia(BPH)and the presence of lower urinary tract stones.Methods:We retrospectively reviewed the records of men with lower urinary tract stones who ...Objective:To examine the relationship between benign prostatic hyperplasia(BPH)and the presence of lower urinary tract stones.Methods:We retrospectively reviewed the records of men with lower urinary tract stones who presented to three clinical centers in Korea over a 4-year period.We divided the patients into two groups based on the location of urinary stones:Group 1(bladder calculi)and Group 2(urethral calculi).We compared the characteristics of both groups and performed univariate and multivariate analyses with a logistic regression model to investigate the relationship between BPH and lower urinary tract stones.Results:Of 221 patients,194(87.8%)had bladder calculi and 27(12.2%)had urethral calculi.The mean age of Group 1 was higher than that of Group 2(68.9612.11 years vs.55.7414.20 years,p<0.001).The mean prostate volume of Group 1 was higher than that of Group 2(44.4727.14 mL vs.24.706.41 mL,respectively,p<0.001).Multivariate logistic regression showed that age(OR Z 1.075,95%CI:1.023e1.129)and prostate volume(OR Z 1.069,95%CI:1.017e1.123)were independently associated with increased risk for bladder calculi.Upper urinary tract stones and/or hydronephrosis conferred a 3-fold risk for urethral calculi(OR Z 3.468,95%CI:1.093e10.999).Conclusion:Age and prostate volume are independent risk factors for bladder calculi.In addition,men with upper urinary tract disease are at greater risk for urethral calculi,which may migrate from the upper urinary tract rather than from the bladder.展开更多
文摘Polymorphonuclear (PMN) cell count in the ascitic fluid is essential for the diagnosis and management of spontaneous bacterial peritonitis (SBP). To date, PMN cell count is routinely performed by traditional manual counting. However, this method is time-consuming, costly, and not always timely available. Therefore, considerable efforts have been made in recent years to develop an alternative test for a more rapid diagnosis and monitoring of SBP. The use of urinary reagent strips was proposed to achieve an "instant" bedside diagnosis of SBP. A series of reports evaluated the urine strip test for SBP diagnosis and reported promising results. However, a recent large multicenter study revealed a surprising lack of diagnostic effi cacy of the urine screening test for SBP diagnosis. Another method, more recently proposed as an alternative to the manual PMN count, is the measurement of lactoferrin in ascitic fluid, but the data available on the diagnostic value of this test are limited to a single study. However, both urinary reagent strips and ascitic lactoferrin tests are qualitative methods and need, therefore, to be further confirmed by standard cytology of the ascitic fluid. To date, the only quantitative method proposed as a valid alternative to manual PMN counting is automated blood cell counters, commonly used in all laboratories for blood cell counting. Data available in the literature on the diagnostic performance of this method are limited but very promising, and this tool seems to have the potential to replace the manual counting method.
基金supported by the Scientific Research Fund of Health Bureau in Zhejiang Province (2009A089)Scientific Research Fund of Education Bureau in Zhejiang Province (Y200804934)
文摘Objective To investigate oxidative DNA damage in pharmacy technicians preparing antineoplastic drugs at the PIVAS （Pharmacy Intravenous Admixture Service） in two Chinese hospitals. Methods Urinary 8-OHdG served as a biomarker. 5-Fluorouracil （5-FU） concentrations in air, masks and gloves were determined. The spill exposure of each PIVAS technician to antineoplastic drugs was investigated. Eighty subjects were divided into exposed group t, II, and control group I, II. Results 5-FU concentration ratios for gloves and masks in exposed group I were significantly higher than those in exposed group II （P〈0.05 or P〈0.01）. The average urinary 8-OHdG concentrations in exposed group I, control group I, exposed group II, and control group II were 24.69＋0.93, 20.68＋1.07, 20.57＋0.55, and 12.96_＋0.73 ng/mg Cr, respectively. Urinary 8-OHdG concentration in exposed group I was significantly higher than that in control group I or that in exposed group 11 （P〈0.02）. There was a significant correlation between urinary 8-OHdG concentrations and spill frequencies per technician （P〈0.01）. Conclusion There was detectable oxidative DNA damage in PIVAS technicians exposed to antineoplastic drugs. This oxidative DNA damage may be associated with their spill exposure experience and contamination of their personal protective equipment.
文摘BACKGROUND: Urinary trypsin inhibitor (UTI) inhibits the inflammatory response and protects against ischemia-reperfusion (I/R) injury. The inflammatory response is mediated by nuclear factor-kappa B (NF-kappa B) and its related target genes and products such as vascular endothelial cell adhesion molecule and CXC chemokines. We aimed to assess the roles of those mediators in a UTI-treated mouse model of hepatic I/R injury. METHODS: Treatment group 1 (UTI given 5 minutes prior to liver ischemia), treatment group 2 (UTI given 5 minutes after the anhepatic phase) and a control group were investigated. Blood and liver samples were obtained and compared at 1, 3, 6 and 24 hours after reperfusion. RESULTS: Attenuation of pathological hepatocellular damage was greater in the treatment groups than in the control group (P < 0.05). Compared with the control group, the UTI treatment groups showed significantly lower serum alanine aminotransferase and aspartate aminotransferase levels, decreased myeloperoxidase activity, and reduced NF-kappa B activation. Also downregulated was the expression of tumor necrosis factor-alpha, cytokine-induced neutrophil chemoattractant, and macrophage inflammatory protein-2 at the mRNA level. P-selectin protein and intercellular adhesion molecule-1 protein expression were also downregulated. In addition, the treatment group I showed a better protective effect against I/R injury than the treatment group 2. CONCLUSIONS: UTI reduces NF-kappa B activation and downregulates the expression of its related mediators, followed by the inhibition of neutrophil aggregation and infiltration in hepatic I/R injury. The protective role of UTI is more effective in prevention than in treatment.
文摘Background We randomly sampled a healthy community to evaluate the prevalence and associated risk factors of urinary incontinence. Methods The survey was performed in Fuzhou, China. Of women over twenty years of age in the city, 3.0% were randomly selected and 4684 evaluated by Bristol Female Urinary Tract Symptoms Questionnaire. Results Of the women in Fuzhou, 19.0% had urinary incontinence. The prevalence of stress incontinence, urge incontinence and mixed incontinence was 16.6% (n=777), 10.0% (n=468), 7.7% (n=360) respectively. The prevalence of the three types of urinary incontinence increased significantly with age (P<0.01). In multiple logistic models, age (OR, 1.3, 95%CI, 1.1-1.4), vaginal delivery (3.0, 1.9-4.7), parity >2 (2.1, 1.5-2.9), hypertension (2.7, 1.4-5.6), constipation (2.6, 1.8-3.8), alcohol consumption (4.7, 1.1-20.2), episiotomy (1.7, 1.4-2.0), higher body mass index (BMI, 1.8, 1.5-2.2) and unskilled worker (0.7, 0.5-0.8) were potential risk factors for stress incontinence. Urge incontinence was associated with age (OR, 1.3, 95%CI, 0.9-1.3), menopause (1.6, 1.1-2.4), Caesarean delivery (0.2, 0.1-0.5), parity >2 (2.6, 1.8-3.8), constipation (2.3, 1.4-3.7), foetal birthweight (1.7, 1.1-2.4), episiotomy (1.4, 1.1-1.8), higher BMI (1.5, 1.2-2.0) and unskilled worker (0.7, 0.5-0.9). Conclusions The prevalence of urinary incontinence and its subtypes in Chinese women is lower than that of occidental women. In China, age, vaginal delivery, parity, hypertension, constipation, alcohol consumption, episiotomy, higher BMI are potential risk factors for stress incontinence. Urge incontinence is associated with age, menopause, Caesarean delivery, parity, constipation, foetal birthweight, episiotomy, higher body mass index.
文摘Small vessel disease （SVD） is responsible for brain chronic circular disorder,and accounts for 20%–30%cases of ischemic stroke as well as cerebral hemorrhage,and to a great extent,encephalopathy.Binswanger’s disease and multiple small strokes,which are common in older people,are also closely associated with SVD.These disorders often cause decline in cognition,vascular dementia,impairment in gait and balance,mood depression,and urinary incontinence,and often brings great social and economic burdens.SVD-related encephalopathy increases the incidences of fall,disability and death in elderly people.With the aging of the society,more attention should be paid to the importance of early diagnosis and prophylactic treatment of SVD.Here the clinical manifestations and pathophysiology of SVD are reviewed.
文摘Summary: In order to study the association between lower urinary tract infection and cystitis glandularis (CG), 120 cases of CG were diagnosed by cystoscopic biopsy in the suspicious foci of the bladder. Among them, 72 cases were subjected to bacterial counting culture of urine and microscopic examination of urinary sediment, and 60 cases to fluorescence quantitative polymerase chain reaction (FQ-PCR) assay to detect HPV, CMV and HSV DNA in urine samples. In the 72 cases of CG, the positive rate of bacterial counting culture of urine was 15.3 % (11/72), and gray zone rate was 18.1 % (13/72). 31.9 % (23/72) patients were positive in bacterioscopy of urinary sediment. There was statistically significant difference as compared with the control group (P<0.01). Only 4 of 60 urine samples were positive by FQ-PCR in detection of the three viruses mentioned above with the positive rate being 6.67 %. Compared with the control group, there was no significant difference (P>0.05). It was concluded that the genesis of CG was closely correlated with the chronic lower urinary tract infection, especially caused by Esch coli.
文摘AIM To report the results of the International Nosocomial Infection Control Consortium(INICC) study conducted in Quito, Ecuador.METHODS A device-associated healthcare-acquired infection(DAHAI) prospective surveillance study conducted from October 2013 to January 2015 in 2 adult intensive care units(ICUs) from 2 hospitals using the United States Centers for Disease Control/National Healthcare Safety Network(CDC/NHSN) definitions and INICC methods. RESULTS We followed 776 ICU patients for 4818 bed-days. The central line-associated bloodstream infection(CLABSI) rate was 6.5 per 1000 central line(CL)-days, the ventilator-associated pneumonia(VAP) rate was 44.3 per 1000 mechanical ventilator(MV)-days, and the catheterassociated urinary tract infection(CAUTI) rate was 5.7 per 1000 urinary catheter(UC)-days. CLABSI and CAUTI rates in our ICUs were similar to INICC rates [4.9(CLABSI) and 5.3(CAUTI)] and higher than NHSN rates [0.8(CLABSI) and 1.3(CAUTI)]- although device use ratios for CL and UC were higher than INICC and CDC/NSHN's ratios. By contrast, despite the VAP rate was higher than INICC(16.5) and NHSN's rates(1.1), MV DUR was lower in our ICUs. Resistance of A. baumannii to imipenem and meropenem was 75.0%, and of Pseudomonas aeruginosa to ciprofloxacin and piperacillin-tazobactam was higher than 72.7%, all them higher than CDC/NHSN rates. Excess length of stay was 7.4 d for patients with CLABSI, 4.8 for patients with VAP and 9.2 for patients CAUTI. Excess crude mortality in ICUs was 30.9% for CLABSI, 14.5% for VAP and 17.6% for CAUTI. CONCLUSION DA-HAI rates in our ICUs from Ecuador are higher than United States CDC/NSHN rates and similar to INICC international rates.
文摘Background The composition of the lung preservation solution used in lung graft procurement has been considered the key to minimize lung injury during the period of ischemia. Low-potassium dextran glucose （LPDG）, an extracellular-type solution, has been adopted by most lung transplantation centers, due to the experimental and clinical evidences that LPDG is superior to intracellular-type solutions. Ulinastatin has been shown to attenuate ischemia-reperfusion （I/R） injury in various organs in animals. We supposed that the addition of ulinastatin to LPDG as a flushing solution, would further ameliorate I/R lung injury than LPDG solution alone.Methods Twelve male New Zealand white rabbits were randomly divided into 2 groups. Using an alternative in situ lung I/R model, the left lung in the control group was supplied and preserved with LPDG solution for 120 minutes. In the study group 50 000 U/kg of ulinastatin was added to the LPDG solution for lung preservation. Then re-ventilation and reperfusion of the left lung were performed for 90 minutes. Blood gas analysis （PaO2, PaCO2）, mean pulmonary artery pressure （MPAP） and serum TNF-α level were measured intermittently. The pulmonary water index （D/W）, tissue myeloperoxidase （MPO） activity, tissue malondialdehyde （MDA） content and morphologic changes were analyzed.Results The study group showed significantly higher PaO2 and lower MPAP at the end of reperfusion. Serum TNF-α level, left lung tissue MPO and MDA in the study group were significantly lower than those in the control group. D/W and pathologic evaluation were also remarkably different between the two groups.Conclusions This study indicated that better lung preservation could be achieved with the use of an ulinastatin modified LPDG solution. Ulinastatin further attenuated lung I/R injury, at least partly by reducing oxidative reactions,inhibiting the release of inflammatory factors and neutrophils immigration.
基金Supported by grants from the Institute de Salud Carlos III No.C03/02,No. G03/156
文摘AIM: To assess the usefulness of urinary trypsinogen-2 test strip, urinary trypsinogen activation peptide (TAP),and serum and urine concentrations of the activation peptide of carboxypeptidase B (CAPAP) in the diagnosisof acute pancreatitis.METHODS: Patients with acute abdominal pain and hospitalized within 24 h after the onset of symptoms were prospectively studied. Urinary trypsinogen-2 was considered positive when a clear blue line was observed (detection limit 50 μg/L). Urinary TAP was measured using a quantitative solid-phase ELISA, and serum and urinary CAPAP by a radioimmunoassay method.RESULTS: Acute abdominal pain was due to acute pancreatitis in 50 patients and turned out to be extrapancreatic in origin in 22 patients. Patients with acute pancreatitis showed significantly higher median levels of serum and urinary CAPAP levels, as well as amylase and lipase than extrapancreatic controls. Median TAP levels were similar in both groups. The urinary trypsinogen-2 test strip was positive in 68% of patients with acute pancreatitis and 13.6% in extrapancreatic controls (P<0.01). Urinary CAPAP was the most reliable test for the diagnosis of acute pancreatitis (sensitivity 66.7%, specificity 95.5%, positive and negative predictive values 96.6% and 56.7%, respectively), with a 14.6 positive likelihood ratio for a cut-off value of 2.32 nmol/L.CONCLUSION: In patients with acute abdominal pain,hospitalized within 24 h of symptom onset, CAPAP in serum and urine was a reliable diagnostic marker of acute pancreatitis. Urinary trypsinogen-2 test strip showed a clinical value similar to amylase and lipase.Urinary TAP was not a useful screening test for the diagnosis of acute pancreatitis.
文摘Objective:Percutaneous nephrolithotomy(PCNL)is commonly used in the management of large renal stones.Postoperative infections are one of the most common complications of this procedure.The present study is to determine and assess the factors that may increase the risk to develop fever and urinary sepsis after PCNL.Methods:A total of 60 patients(38 males and 22 females)with a mean age of 40.25 years enrolled in this study in Sulaimania Teaching Hospital.Patients had renal stone disease need operation with different socioeconomic status,body mass index and different type and size of stones were included in this study.Patients with preoperative positive urine culture and sensitivity were excluded.Preoperative investigations done for all patients.All Patients received prophylactic antibiotic gentamicin intravenously at the induction of anaesthesia.Renal pelvis urine sample were taken from all patients after puncturing the pelvicalyceal system and send for culture and sensitivity.Patients were monitored closely in the postoperative period for the development of fever and sepsis.Results:Mean duration of the operations was 77.08 min ranged 40e120 min.All patients had postoperative nephrostomy tube.Seventeen(28.33%)patients developed post PCNL fever and the statistically significant factors for post PCNL fever were diabetes mellitus(DM)(p Z 0.001),stone burden(p Z 0.001),number of the stones(p<0.001),degree of hydronephrosis(p Z 0.001),duration of the operation(p<0.001),residual stones(p Z 0.001)and number of tracts(p Z 0.038).Three(5.00%)patients developed post PCNL sepsis,and the statistically significant risk factors for post PCNL sepsis were duration of the operation(p Z 0.013)and intraoperative blood loss,postoperative drop in haemoglobin(HB)level(p Z 0.046).Conclusion:DM,staghorn stones,degree of hydronephrosis,duration of the operation and number of tracts are risk factors for post PCNL fever,while number of stones,intraoperative blood loss,duration of the operation and residual stones are risk factors for post PC
文摘The emergence of antibiotic resistant bacteria in the healthcare is a serious concern.In the Healthcare premises precisely intensive care unit are major sources of microbial diversity.Recent findings have demonstrated not only microbial diversity but also drug resistant microbes largely habitat in ICU.Pseudomonas aeruginosa found as a part of normal intestinal flora and a significant pathogen responsible for wide range of ICU acquired infection in critically ill patients.Nosocomial infection associated with this organism including gastrointestinal infection,urinary tract infections and blood stream infection.Infection caused by this organism are difficult to treat because of the presence of its innate resistance to many antibiotics(b-lactam and penem group of antibiotics),and its ability to acquire further resistance mechanism to multiple class of antibiotics,including Beta-lactams,aminoglycosides and fluoroquinolones.In the molecular evolution microbes adopted several mechanism to maintain genomic plasticity.The tool microbe use for its survival is mainly biofilm formation,quorum sensing,and horizontal gene transfer and enzyme promiscuity.Such genomic plasticity provide an ideal habitat to grow and survive in hearse environment mainly antibiotics pressure.This review focus on infection caused by Pseudomonas aeruginosa,its mechanisms of resistance and available treatment options.The present study provides a systemic review on major source of Pseudomonas aeruginosa in ICU.Further,study also emphasizes virulence gene/s associated with Pseudomonas aeruginosa genome for extended drug resistance.Study gives detailed overview of antibiotic drug resistance mechanism.
文摘To evaluate the efficacy and safety of plasmakinetic resection of the prostate （PKRP） versus transurethral resection of the prostate （TURP） for the treatment of patients with benign prostate hyperplasia （BPH）, a meta-analysis of randomized controlled trials was carried out. We searched PubMed, Embase, Web of Science and the Cochrane Library. The pooled estimates of maximum flow rate, International Prostate Symptom Score, operation time, catheterization time, irrigated volume, hospital stay, transurethral resection syndrome, transfusion, clot retention, urinary retention and urinary stricture were assessed. There was no notable difference in International Prostate Symptom Score between TURP and PKRP groups during the 1-month, 3 months, 6 months and 12 months follow-up period, while the pooled Qmax at 1-month favored PKRP group. PKRP group was related to a lower risk rate of transurethral resection syndrome, transfusion and clot retention, and the catheterization time and operation time were also shorter than that of TURP. The irrigated volume, length of hospital stay, urinary retention and urinary stricture rate were similar between groups. In conclusion, our study suggests that the PKRP is a reliable minimal invasive technique and may anticipatoriiy prove to be an alternative electrosurgical procedure for the treatment of BPH.
文摘Background Dysregulation of apoptosis has been implicated not only in carcinogenesis and tumor progression but also in tumor recurrence. We investigated whether the expression of X-linked inhibitor of apoptosis （XIAP） might predict early recurrence in patients with non-muscular invasive bladder cancer. Methods The cohort comprised 176 consecutive patients with primary superficial bladder cancer treated with transurethral resection. Immunohistochemical staining using the standard avidin-bioUn-peroxidase technique and RT-PCR were used to detect XIAP protein and mRNA expressions in cancer tissues. The relationship between XIAP expression and clinicopathological characteristics, cancer recurrence were analyzed. Results XIAP expression was observed in 108 cases （61.4%） and no expression in 68. There was no correlation between XIAP expression rate and the tumor pathological grade, but was an apparent trend toward the increased XIAP levels from well （G1） to poor （G3） differentiated cancer. Eighty-two （46.6%） patients experienced tumor recurrence at a mean of 28.6 months of the follow-up; 66 of them expressed XIAP （61.1%） and 16 were XIAP negative （23.5%）. Twelve patients presented with invasive disease at the time of relapse and all of them expressed XIAP. Patients without XIAP expression or with low tumor grades had significantly higher recurrence-free survival than those with XIAP expression （log rank test ,P=-0.0015） or high tumor grades （log rank test P〈0.001）. Multivariate analysis revealed that XIAP expression, tumor grade, and tumor number were independent predictors for the recurrence of non-muscular invasive bladder cancer （P=-0.004, 0.016, and 0.043, respectively）. Conclusions XIAP may be considered as a new independent prognostic marker for early recurrence of non-muscular invasive bladder cancer.
文摘Background Traumatic damage to fascial and muscular support structures during childbirth may be a major factor of the development of stress urinary incontinence （SUI） and pelvic organ prolapse （POP）. The aim of this study was to prospectively investigate the role of different childbirth strategies on POP and SUI. Methods A total of 120 selected pregnant women were recruited and divided into two groups： vaginal delivery group （n=72） and selective cesarean delivery group （n=48）. The women were questioned with SUI sheet and estimated with POP quantification （POP-Q） within 6-8 weeks after delivery. The correlations of SUI and results of POP-Q with the strategies of delivery were analyzed, ttest, X2 test, and the Mann-Witney test were used for statistical analysis. Results Among the 120 women, SUI was developed during 29-30 gestational weeks in 20 patients （16.6%）, of whom 14 （70%） had symptoms of SUI till 6 weeks postpartum. Totally 20 （16.6%） women had SUI symptoms after delivery. The prevalence of postpartum SUI was positively correlated with the occurrence of SUI during 29-30 gestational weeks （P〈0.001）. In the vaginal delivery group, 100% of the women suffered form urinary prolapse 6 weeks postpartum, while 87.5% of those in the selective cesarean delivery group developed POP （P〈0.01）. The percentages of the first- and second-degree urinary prolapse in the vaginal delivery group were 20.8% and 79.2% respectively, which were significantly different from those in the selective cesarean delivery group （64.6% and 22.9%; both P=0.000）. Conclusions Pregnancy and delivery play an etiologic role in the development of SUI and POP. The onset of SUI during late pregnancy implies a significant risk of postpartum SUI symptoms. The prevalence of POP is significantly higher after vaginal delivery than after cesarean delivery.
文摘In this study, we examined the relationship between sex hormone levels and lower urinary tract symptoms （LUTS） in men with benign prostatic hyperplasia （BPH） who underwent transurethral surgery. The study was conducted in 158 patients who came to our hospital for surgery. Clinical conditions were assessed by body mass index （BMI）, digital rectal examination, International Prostate Symptom Score （IPSS） and transrectal ultrasound （TRUS）. The levels of sex hormones （including total testosterone （TT）, estradiol （E2）, progesterone （P）, luteinizing hormone （LH）, follicle-stimulating hormone （FSH） and prolactin （PRL）） and prostate-specific antigen （PSA） were reviewed. Correlations were determined through statistical analysis. The mean age was 72.06 _＋ 8.68 years. The total IPSS was significantly associated with the TT level （r = -0.21, P = 0.01）. Other sex hormone levels were not correlated with total IPSS. However, some ratios such as E2/TT （r = 0.23, P = 0o00） and FSH/LH （r = -0.17, P = 0.04） were associated with total IPSS. Further analysis showed that the nocturia was associated with age （r = 0.16, P = 0.04）, BMI （r = 0.21, P = 0.01）, and TT （r = -0.19, P = 0.02）. Moreover, we divided the patients into two subgroups based on IPSS severity （〈20 or 〉20）. The mean TT level was in the normal range, but it was significantly related to the presence of severe LUTS. In summary, our study has shown that the severity of LUTS is associated with TT, EJTT and FSH/LH in men who underwent prostate surgery. Increasing nocturia was observed in lower testosterone patients. Additional larger studies are needed to elucidate the potential mechanisms.
文摘Objective:To examine the relationship between benign prostatic hyperplasia(BPH)and the presence of lower urinary tract stones.Methods:We retrospectively reviewed the records of men with lower urinary tract stones who presented to three clinical centers in Korea over a 4-year period.We divided the patients into two groups based on the location of urinary stones:Group 1(bladder calculi)and Group 2(urethral calculi).We compared the characteristics of both groups and performed univariate and multivariate analyses with a logistic regression model to investigate the relationship between BPH and lower urinary tract stones.Results:Of 221 patients,194(87.8%)had bladder calculi and 27(12.2%)had urethral calculi.The mean age of Group 1 was higher than that of Group 2(68.9612.11 years vs.55.7414.20 years,p<0.001).The mean prostate volume of Group 1 was higher than that of Group 2(44.4727.14 mL vs.24.706.41 mL,respectively,p<0.001).Multivariate logistic regression showed that age(OR Z 1.075,95%CI:1.023e1.129)and prostate volume(OR Z 1.069,95%CI:1.017e1.123)were independently associated with increased risk for bladder calculi.Upper urinary tract stones and/or hydronephrosis conferred a 3-fold risk for urethral calculi(OR Z 3.468,95%CI:1.093e10.999).Conclusion:Age and prostate volume are independent risk factors for bladder calculi.In addition,men with upper urinary tract disease are at greater risk for urethral calculi,which may migrate from the upper urinary tract rather than from the bladder.
