Objective To find the difference between the collagenase activity and tissue inhibitor of metalloproteinase-1 (TIMP-1) expression level in normal urethral tissue and in urethral scar tissue, and to study the effect of collagenase activity and TIMP-1 expression level on the degradation of urethral scar. Methods The urethral tissues were derived from 10 human surgical specimens of urethral stricture scar and 10 human normal urethral specimens from patients with brain death. The collagenase activity was detected by ELISA assay, and the TIMP-1 mRNA level by RT-PCR. Results The collagenase activity of urethral scar tissue was (15.32±2.29) U and lower than that of normal urethral tissue (24.67±6.78) U, there was significant difference between them (P lt; 0.01). The TIMP-1 expression level of urethral scar tissue was higher than that of normal urethral tissue, there was significant difference between them (P lt; 0.05). Conclusion The high level of TIMP-1 expression and the low collagenase activity in urethral scar tissue may inhibit the degradation of urethral scar, and may be one of important causes of the scar tissue hyperplasia.
Objective To access the efficacy and safety of Holmium laser prostatectomy technique compared to TURP. Methods We searched MEDLINE (1996 to 2004), EMBASE (1984 to 2004), The Cochrane Library (Issue 4, 2004), CNKI, VIP, CMCC and CBMdisc; and handsearched the relevant Chinese journals. Randomized controlled trials (RCT) were included. The quality of trials was evaluated and meta-analysis was performed. Non-randomized controlled trials were also included to evaluate the safety and efficacy. Results We found 4 randomized controlled trials. A total of 480 participants were in the trials ranging from 60 to 200. There was no statistical difference between the two techniques at 12 or 48 months follow-up in terms of quality of life (QOL) improvement（WMD=-0.19, 95%CI -0.81 to 0.44, Z=0.59, P=0.56; WMD=-0.30, 95%CI -0.90 to 0.30, Z=0.98, P=0.33); Qmax improvement（WMD=1.63 ml/s, 95%CI -0.32 to 3.59, Z=1.64, P=0.10; WMD=3.80 ml/s, 95%CI -1.36 to 8.96,Z=1.44, P=0.15); I-PSS or AUA (WMD=-0.06, 95%CI -1.01 to 0.89, Z=0.12, P=0.91; WMD=-1.40, 95%CI -3.91 to 1.11, Z=1.09, P=0.27) and the urethral stricture complication rate (RR=0.75, 95%CI 0.35 to 1.60, Z=0.74, P=0.46). However hospital stay was significantly shorter in the Holmium laser prostatectomy groups (total WMD=-24.89, 95%CI -28.56 to -21.21, Z=13.27, P＜0.000 01). We can not draw consistent conclusions in terms of blood loss according to the present data. One study indicated Holmium laser prostatectomy technique was more cost-effective than TURP. Conclusions In short period Holmium laser prostatectomy is as safe as TURP in terms of hospital stay, urethral stricture and blood loss complication. This new technique is as effiective as TURP in terms of I-PSS (AUA), Qmax and QOL. More RCTs and more long term follow-up is necessary.
Objective To determine whether antibiotic prophylaxis can reduce the risk of postoperative bacteriuria in men undergoing transurethral resection of prostate (TURP) who have sterile preoperative urine. Method MEDLINE, EMBASE and Cochrane Library were searched for RCTs comparing antibiotic prophylaxis and placebo/blank controls for men undergoing TURP with preoperative sterile urine. The search strategy was established according to the Cochrane Prostatic Diseases and Urologic Cancers Group search strategy. Data was extracted by two reviewers using the designed extraction form. RevMan were used for data management and analysis. Results Fifty three relevant trials were searched, of which 27 trials were included and 26 were excluded. Antibiotic prophylaxis significantly decreased the rate of post-TURP bacteriuria.The pooled relative risk (RR) and 95% confidence interval were 0.36 (0.28, 0.46). Conclusions Prophylactic antibiotics could significantly decrease the incidence of post-TURP bacteriuria. Further comparative RCTs and cost-effective should be performed analysis to establish the optimal antibiotic regimes for the benefit of patients undergoing TURP.
Objective To analysis the original articles published in Chinese Journal of Urology and to evaluate the present situation of the clinical and scientific research in the field of urology, providing clue to raise the clinical and scientific research level. Methods Chinese Journal of Urology and Journal of Urology in American were hand-searched and all original articles were divided into eight types and were identified and analyzed. The classes include descriptive studies, therapeutic studies, studies on diagnosis, etiology, prognosis etc. Results The decreased trend year by year were observed for the descriptive studies (χ2=286.179, Plt;0.005), number of such publications accounting for 71.90% in 1980-1984 down to 26.48% in 1999-2001. Number of randomized controlled trials and clinical controlled trials present distinct increasing trend, especially number of RCT increased from none in 1980-1984 to thirteen articles in 1995-1998. The proportion of laboratory research in all original articles have increased greatly and have exceeded that of Journal of Urology. Conclusions The clinical and scientific research level of urology have been elevating in our country, the constituent ratio of descriptive studies is decreasing and that of RCT and CCT is increasing. The constituent ratio of laboratory research has increased greatly and has exceeded that of similar foreign Journal in some years. Attention needs to be paid to this trend and mechanism of it should be further explored.
Objective To evaluate factors such as renal injury grade （Sargent Method）, blunt or penetrative renal injury, injury severity score（ISS）, and shock influencing the need for operation or nephrectomy, and predictive of mortality in renal injury. Methods A well~tesigned questionnaire was used to collect medical records retrospectively. Two hundred and twenty-one cases of renal injury in West China Hospital from 1998 to 2002 were included, logistic regression analysis was used for multi-factors analysis. Results The average age of the 221 cases was 31.6, with 191 males （86.4%） and 30 females （13.6% ）, 175 blunt injuries （79.2%） and 46 penetrative injuries （20.8%）, and 101 concomitant injuries （45.7%）. Six cases died of renal injury （2.7%）. The results of logistic regression showed that the need of operation was related to injury grade, Type of renal injury, and shock significantly. ORs （odd ratios） were 5. 965 with 95% CI 2. 767 to 12. 859, 4. 667 with 95% CI 1. 725 to 12. 628, and 2. 547 with 95% CI 1. 684 to 3. 936 respectively. The need of nephrectomy was significantly related to injury grade with OR 11. 550 and 95% CI 4. 253 to 31. 366. The death was significantly related to ISS with OR 1. 263 and 95% CI 1. 082 to 1. 411. Conclusions The results of our data suggest the need of operation depends on injury grade, blunt or penetrative renal injury, and shock. The need of nephrectomy depends on injury grade. The death is related to ISS.