ObjectivesTo evaluate the effects of Q-syte separating film needleless closed transfusion connector in flushing chamber of three-cavity urethral catheter.MethodsTo retrospectively analyze the patients who underwent transurethral resection of bladder tumor for non muscle-invasive bladder cancer from January 2015 to July 2016 in Zhongnan Hospital of Wuhan University. After terminating the continuous bladder irrigation, the observed group used Q-syte separating film needleless closed transfusion connector to seal the flushing chamber of three-cavity urethral catheter, and control group used conditional approach to connect drainage bag. The degree of comfort and satisfaction of patients, urinary tract infection, time of stopping bladder irrigation and bladder perfusion time between two groups were assessed.ResultsA total of 88 patients were included involving 63 (72%) males and 25 (28%) females with a mean age of 60.2±4.7 years. There were no significant differences between two groups in age, gender, BMI, and complications (P>0.05). Compared to control group, case group had higher level of comfort degree (mild discomfort: 86.4% vs. 25.0%, P<0.001; moderate discomfort: 13.6% vs. 52.3%, P<0.001; severe discomfort: 0.0% vs. 22.7%, P=0.001), satisfaction degree (97.9±2.1 vs. 84.5±3.9, P<0.001), and lower rates of urinary tract infection (11.4% vs. 29.5%, P=0.034). In addition, the case group spent shorter time in terminating bladder irrigation (50.48±1.78 vs. 207.74±5.41, P<0.001) and bladder perfusion (141.47±3.25 vs. 205.35±5.17, P<0.001). All differences were statistical significance.ConclusionsApplication of Q-syte separating film needleless closed transfusion connector for sealing flushing chamber of three-cavity urethral catheter after continuous bladder irrigation could promote the degree of comfort and satisfaction of patients, and decrease the rate of urinary tract infection, as well as the working efficiency of health care professionals.
Bladder cancer is a common malignant tumor of the urinary system. The incidence and mortality of bladder cancer in China have been at a high level. In the past, people generally believed that the bladder was a sterile environment, but it has been found that there are symbiotic microorganisms in the bladder. In addition, microorganisms and their metabolites in urine may be involved in the occurrence and development of various urinary system diseases such as bladder cancer. At the same time, microorganisms and their component products such as Bacillus Calmette-Guerin vaccine play an important role in the treatment of bladder cancer. This article reviews the research progress of urinary tract microorganisms and the occurrence, development and treatment of bladder cancer, and aims to provide new ideas for the early diagnosis and treatment, prevention and prognosis evaluation of bladder cancer.
ObjectiveTo analyze the disease burden of prostate, bladder and kidney cancers attributable to smoking in China from 1990 to 2019. MethodsBased on the global burden of disease study 2019, the current situation of the disease burden of prostate, bladder and kidney cancers attributable to smoking was analyzed by using the population attributable fraction (PAF), deaths and disability-adjusted life years (DALYs). Furthermore, the annual percent change (APC) and the average annual percent change (AAPC) were calculated by joinpoint regression analysis to describe the long-term trends of the smoking-attributable burden of these three cancers from 1990 to 2019. ResultsThere were an estimated 18 800 cases of deaths and 393 106 person-years of DALYs for bladder cancer caused by smoking in 2019. The age-standardized mortality and DALY rate decreased by 0.41% and 0.39% per year from 1990 to 2019, respectively. For prostate cancer, smoking was estimated to have caused 5 016 cases of deaths and 98 276 person-years of DALYs in 2019. The age-standardized mortality and DALY rate decreased by 0.28% and 0.25% per year from 1990 to 2019, respectively. For kidney cancer, the deaths and DALYs attributable to smoking were 4 935 cases and 120 620 person-years, respectively. The standardized mortality and DALY rates increased by 3.03% and 2.98% per year from 1990 to 2019. Additionally, males suffered from a higher disease burden of these three cancers attributable to smoking than females. The elderly population had a higher smoking-attributable disease burden than the younger population. ConclusionThe situation of the disease burden of bladder, prostate and kidney cancers attributable to smoking is still serious in China, which has substantial disparities in different groups. Specifically, males and the elderly are the high-risk groups for the smoking-attributable burden. Among the three cancers, bladder cancer has the highest burden and kidney cancer has the largest burden increase during 1990-2019.
Objective To establish the artificial bladder reflex arc by the normal body reflex pathway above the horizon of spinal cord injury to reinnervate the flaccid bladder and restore bladder micturition function. Methods An intradural microanastomosis was performed on the L6 ventral root tothe S2 ventral root. After axonal regeneration,the “patellar ligament-spinal cord center-bladder” reflex pathway was reestablished. A longterm function of the reflex arc was observed in the nerve electrophysiological experiment, detrusor electromyography experiment, and urodynamic testing 8 months after anastomosis. Results Trains of the stimuli(200 μV,5 ms) in the left L6 dorsal root and the nerve at the anastomosizedsite resulted in motor evoked potential from the disal to the anastomosized site before and after the spinal cord was destroyed horizontally between S1 and S4 segment levels in 2 Beegle dogs.The figure and amplitude of the evoked potential were similar to those of the control and general stability which showed anoninterventional wave. The urodynamic test revealed a rapid increase of the bladder pressure and a minor increase in the abdominal pressure. This showed that the bladder detrusor mainly resulted in the pressure increase.The bladder pressure increased to 60% of the normal on average compared with the controls when resulted in the left L6 dorsal root and the nerve anastomosized site were stinulated. Conclusion The long-term observation by the nerveelectrophysiological experiment, detrusor electromyography experiment, and urodynamic test indicate that the new artificial reflex arc can be established successfully. The somatic motor axons can regenerate into the parasympathetic endoneurial tubes of the autonomic nerve.
Objective To investigate the biocompatibil ity of sil ica gel embedded permanent magnets of themicturition alert device dedicated to neurogenic bladder. Methods According to the national standards of biologicalevaluation of medical equipment (GB/T 16886), Shanghai Biomaterial Research and Test Center was confided to evaluate the biocompatibil ity of sil ica gel embedded permanent magnets both in vitro and in vivo, including cytotoxicity test, sensitization test, primary skin irritant test and acute general toxicity test. The cytotoxicity test was performed according to the agar diffusion method. The L929 cell discoloration index and cell lysis index were counted at 24 hours after the action of the specimen. The sensitization test was performed according to the maximal dose method. The skin response was evaluated in 30 male albino guinea-pigs at 24 and 48 hours after the routine induction and provocation of leaching l iquors of the specimen. The primary skin irritant test was evaluated in 2 male healthy New Zealand rabbits according to the local tissue response at 24, 48 and 72 hours after intradermal injection of leaching l iquors of the specimen. The acute general toxicity test was evaluated in 10 male Kumming mice musculus albus according to animal condition at 4, 24, 48 and 72 hours after injection of leaching l iquors of the specimen through the caudal vein. Both the general reaction of canines and the pathology of the local bladder walls were observed at 2, 4 and 8 weeks after a permanent magnet was fixed on the anterior wall of urinary bladder in three canines. Results No sensitization, no stimulation and no acute general toxicity were observed except sl ight cytotoxicity to sil ica gel embeddedpermanent magnets. After implantation of a permanent magnet, the canines showed excellent tolerace, which manifested as no abnormal ity in spirit, appetite, urine and stool, healed wounds and no infection. Adhesions occurred between the epiploon and the bladder wall around the permanent magnet in two canines at 2 and 4 weeks, and between the lower abdominal wall and the bladder wall around the permanent magnet in the other canine at 8 weeks. The local bladder wall below permanent magnet was thickened, the fibrous capsule around the permanent magnet was thin, but the bladder mucosa was normal. Inflammatory reaction such as congestion, edema and inflammatory cells lessened from the serosa layer to the mucosa layer microscopically. Conclusion Sil ica gel embedded permanent magnets used in the micturition alert device dedicated to neurogenic bladde has excellent biocompatibil ity and meet the criteria for cl inical appl ication．
Objective To evaluate the cytocompatibility of collagenmembraneswith transitional cells of rabbit in vitro and to discuss the possibility of the collagen membranes as urologic tissue engineering scaffolds. Methods Primary cultured transitional cells isolated from New Zealand rabbits were implantedon collagen membranes at 1×105 cells/cm2. The changes of cell adhering were observed by inverted microscope and scanning electron microscope 2, 12 and 24hours later. The experiment was divided into 4 groups: non-cell group (black control) culture medium group(negative control), extract medium from Polyvinyl chloride group(positive control) and extract medium from collagen membranes group(experimental group). The cells of generations 2 to 4 were implanted in 96-hole-plank at 1×104 cells every hole. And every group had 5 holes. Then absorption coefficient were detected at the wave length of 490 nm by MTT assay. Then the cytotoxicity and cytocompatibility were evaluated by comparison of the numbers of absorptioncoefficient.Results The bladder transitional cells began to adhere to the collagen membrane 2 hours after implanting, and the number of the adhered cells increased with time.The actual absorption coefficient of experimental groups was 0.590±0.024,1.065±0.040 and 1.129±0.074 after 24, 72 and 120 hours. The actual absorption coefficient of negative control group was 0.639±0.068,1.022±0.044 and 1.087±0.111. The actual absorption coefficient of positive control group was 0.302±0.029,0.653±0.083 and 0.694±0.031. There was significantdifference between the experimental group and positive control (Plt;0.01), and no significant difference between the experimental group and negative control(Pgt;0.05).Conclusion Collagen membrane has good cytocompatibility withtransitional cells and no cytotoxity. It can be used as scaffolds of urologic tissue engineering.
Objective To systematic review of bladder cancer antigen (BTA) stat and urine cytology (UC) in the diagnosis of bladder cancer. Methods MEDLINE (Jan.1966 to June 2008), EMbase (Jan.1988 to June,2008), Cochrane Library (Issue 1,2008), CMCC (1979 to June, 2008) and CNKI (Jan.1979 to June, 2008) were searched for studies about BTA stat and cytology in the diagnosis of bladder cancer. The search strategy was made according to the Collaborative Review Group search strategy. Quality of included trials wa assessed by quality assessment of diagnostic accuracy studies.Data were extracted by two reviewers using the designed extraction form. The software MetaDiSc1.4 was used to review management and data analysis. Results In total, 71 relevant studies were searched, of which 13 were included and 58 were excluded, with 3 733 patients involved. Heterogeneity (except for threshold effect) was found within these studies. A meta-analysis was performed using random effect model. Pooled accuracy indicators of sensitivity, specificity, positive likelihood ratio (LR) , negative LR and diagnostic odds ratio (dOR) and 95%CI of BTA stat and UC were 0.68 (0.65,0.70), 0.74 (0.72, 0.76), 2.51 (2.04, 3.09), 0.46 (0.38, 0.55), 5.66 (3.87, 8.29) and 0.41 (0.39, 0.44), 0.97 (0.97, 0.98), 12.64 (7.58, 21.08), 0.62 (0.55, 0.71), 22.16 (12.38, 39.66), respectively. The sensitivity of both methods increased as the higher of tumor grade and stage, and the incipient tumor was higher than the recurrence. Area under curve (AUC) of SROC curve of BTA stat and UC were 0.753 5 and 0.711 9, and Q index were 0.696 3 and 0.662 4, respectively. Conclusions The performance of urine BTA stat is moderate in the diagnosis of bladder tumor. It can not replace the traditional urine cytology and diagnose the bladder cancer alone, but which can be an available noninvasive examination and an important adjunct of preoperative detecting and postoperative monitoring of bladder tumor.
ObjectiveTo investigate the expression and clinical significance of HIST1H1B gene in bladder cancer.MethodsInformation on HIST1H1B in the dataset GSE13507 was downloaded from the GEO database. Discrepancy in expression of HIST1H1B in normal tissues and bladder cancer tissues was analyzed by t-test. Survival analysis was performed by using Log-rank algorithm. The association between HIST1H1B gene expression and clinicpathological features was analyzed using Chi-square test. Gene enrichment analysis (GSEA) was performed to explore possible pathways of HIST1H1B involved in bladder cancer.ResultsHIST1H1B was down-regulated in normal tissues and highly expressed in bladder cancer tissues (P=0.002 5). The expression of HIST1H1B was associated with age, gender, T stage, M stage, N stage, disease stage, but not associated with invasiveness and progression. Whether in overall survival (HR=1.732, 95%CI 1.070 to 2.803) or tumor-specific survival (HR=2.000, 95%CI 0.996 to 4.017), patients with high expression of HIST1H1B were significantly lower than that in patients with low expression (P<0.05). GSEA results showed that HIST1H1B may influence the occurrence and development of bladder cancer by regulating MYC signaling pathway V2, G2M checkpoint, E2F signaling pathway, spermatogenesis, mitotic spindle, etc.ConclusionsHIST1H1B may be a biomarker for determining the prognosis of bladder cancer and a target for treatment of bladder cancer.
Objective To review the study on adi pose derived stem cells (ADSCs) in the therapy of urological diseases. Methods The recent l iterature concerning ADSCs in bladder repair, urethral reconstruction, incontinence treatment, and erectile dysfunction treatment was reviewed. Results The appl ication of tissue engineering using ADSCs has made significant achievements in the treatment of urological diseases and in animal studies, and has been initially used in cl inicaland has achieved a good therapeutic effect. Conclusion Tissue engineering using ADSCs has good prospects in the study on urological diseases, and is expected to widely used in the treatment of urological diseases.
ObjectiveTo prepare a composite scaffold using bladder acellular matrix (BACM) and polyurethane (PU) for bladder repair and regeneration, and to evaluate its mechanical properties and biocompatibility. MethodsFresh bladder tissues were obtained from New Zealand rabbits and then treated with 1%SDS and 1%Triton X-100 to obtain BACM. The BACM was combined with PU to fabricate PU-BACM composite scaffold. The tensile strength and elongation at break of BACM and PU-BACM scaffolds were tested. Scaffolds and extracts of scaffolds were prepared to evaluate the biocompatibility. For cell-proliferation analysis, cell counting kit 8 method was used at 1, 3, 5, and 7 days after co-culture of human bladder smooth muscle cell (HBSMC) and scaffolds. The cell cycle was tested by flow cytometry after HBSMC co-cultured with extracts of scaffolds and DMEM culture medium (control group) for 24 hours. Finally, 12 New Zealand rabbits were used to establish the model of bladder repair and regeneration. Incision of 5 mm was made on the bladder, and PU-BACM scaffold was sutured with the incision. The rabbits were sacrificed at 10, 20, 40, and 60 days after surgery to observe the inflammatory cell infiltration, new tissues formation, and regeneration of epithelium by HE staining. ResultsThe tensile strength of BACM and PU-BACM composite scaffold was (5.78 ± 0.85) N and (11.88 ± 3.21) N, and elongation at break was 14.46%±3.21% and 23.14%±1.32% respectively, all showing significant diffeence (t=3.182, P=0.034；t=4.332, P=0.012). The cell-proliferation rates of controls, PU, BACM, and PU-BACM were 36.78%±1.21%, 30.49%±0.89%, 18.92%±0.84%, and 22.42%±1.55%, it was significantly higher in PU-BACM than BACM (P<0.05). In the bladder repair and regeneration experiment, inflammatory cell infiltration was observed at 10 days after operation, and reduced at 20 days after implantation. In the meanwhile, the degradation of scaffolds was observed in vivo. The regeneration of epithelium could be observed after 40 days of implantation. At 60 days after implantation, in situ bladder tissue formed. ConclusionPU-BACM composite scaffold has higher mechanical properties and better biocompatibility than BACM scaffold. PU-BACM composite scaffold will not lead to strong immune response, and new bladder tissue can form in the in vivo rabbit bladder repair experiment. These results can provide research basis and theoretical data for further study.