PURPOSE:Nocturnal urine volume and bladder reservoir function are key pathogenic factors behind monosymptomatic nocturnal enuresis (MNE). We investigated the predictive value of these together with other demographic and clinical variables for response to first-line treatments in children with MNE. MATERIALS AND METHODS:A randomized, controlled, international, multicenter study was conducted in 324 treatment-naïve children (6-14 years old) with primary MNE. The children were randomized to treatment with or without prior consideration of voiding diaries. In the group where treatment choice was based on voiding diaries, children with nocturnal polyuria and normal maximum voided volume (MVV) received desmopressin (dDAVP) treatment, and children with reduced MVV and no nocturnal polyuria received an enuresis alarm. In the other group, treatment with dDAVP or alarm was randomly allocated. RESULTS:A total of 281 children (72% males) were qualified for statistical analysis. The change of responding to treatment was 21% higher in children where treatment was individualized compared to children where treatment was randomly selected (risk ratio = 1.21 [1.02-1.45], P = .032). In children with reduced MVV and no nocturnal polyuria (35% of all children), individualized treatment was associated with a 46% improvement in response compared to random treatment selection (risk ratio = 1.46 [1.14-1.87], P = .003). Furthermore, we developed a clinically relevant prediction model for response to dDAVP treatment (receiver operating characteristic curve 0.85). CONCLUSIONS:The present study demonstrates that treatment selection based on voiding diaries improves response to first-line treatment, particularly in specific subtypes. Information from voiding diaries together with clinical and demographic information provides the basis for predicting response.

Objective:To explore the significance of home-uroflowmetry (HUF) in assessing primary nocturnal enuresis (PNE).Methods:From December 2019 to March 2021, 41 children visited our urology clinic and completed office-uroflowmetry (OUF) and 48 h HUF as required. Among them, 23 boys had an average age of (7. 3±2. 0) (5-13) years and the weekly number of enuresis ranged from 2 to 7 times; 18 girls had an average age of (7. 7±2. 3) (5-14) years and the weekly frequency of enuresis ranged from 1 to 7 times. Voided volume (VV) , maximal urine flow rate (Qmax) , average urine flow rate (Qave) , voiding time (VT) and urine flow curve were recorded for statistical analysis.Results:Forty-one and 568 voids (including 30 VV<50. 0 ml not included for statistical analysis) were recorded by OUF and 48 h HUF respectively. And 24 h urination frequency, nocturnal urination frequency, 24 h VV and nocturnal urine volume of PNE children recorded by 48 h HUF were (6. 9±1. 5) times, (1. 1± 0. 5) times, (1 098. 1±163. 7) ml and (289. 6±87. 2) ml respectively. VV measured by 48 h HUF and OUF was (163. 5±33. 0) vs. (209. 2±61. 7) ml and the difference was statistically significant ( P<0. 001) ; Qmax (19. 0±3. 2) vs. (20. 6±4. 5) ml/s and the difference was statistically significant ( P< 0. 001) ; Qave (9. 3±1. 9) vs. (10. 3±2. 7) ml/s and the difference was statistically significant ( P= 0. 001) ; VT (17. 9±3. 1) vs. (20. 9±4. 6) s and the difference was statistically significant ( P< 0. 001 ) . Altman-Bland analysis revealed that only 13/41, 20/41, 29/41 and 16/41 points for VV, Qmax, Qave and VT were all within clinically acceptable limits with a poor agreement. Analysis of urine flow curves revealed that the incidence of Staccato urine flow curve was significantly higher in OUF than in HUF (19.5% vs. 6. 3%) . Conclusion:The results of HUF correspond more to the physiological status of children. More real and reliable, HUF is preferentially selected for assessing bladder function in PNE children.

目的 探讨去氨加压素(DDAVP)治疗单症状遗尿症(MNE)患儿症状和睡眠改善情况.方法 选择2018—2020年门诊就诊的69例MNE患儿进行为期12周的DDAVP治疗随访研究,12周后根据遗尿改善情况将患儿分为治疗改善组和无改善组,分析DDAVP治疗对遗尿症状和睡眠质量的影响.结果 基线入组的69例MNE患儿中,7例中途退出随访,最终纳入62例,男34例、女28例,平均年龄(8.77±1.94)岁.接受DDAVP治疗的MNE患儿,基线、第4周、第8周、第12周的遗尿夜晚数、儿童睡眠习惯问卷(CSHQ)总分、遗尿发生时间、平时及周末睡眠时间差异均有统计学意义(P<0.05),第12周遗尿夜晚数和CSHQ总分较基线值明显下降,遗尿发生时间、平时及周末睡眠时间较基线值明显延长,差异均有统计学意义(P<0.05).与无改善组(n=22)相比,第8周、第12周改善组(n=40)的CSHQ总分较低,遗尿发生时间、平时和周末睡眠时间均明显延长,每周遗尿夜晚数减少,差异有统计学意义(P<0.05).从CSHQ评分8个层面得分来看,改善组在就寝习惯、入睡潜伏期、睡眠持续时间、睡眠焦虑、夜醒、异态睡眠及白天嗜睡层面的得分差异均有统计学意义(P<0.05),无改善组仅在睡眠持续时间层面的差异有统计学意义(P<0.05).结论 DDAVP治疗12周可明显改善MNE患儿的症状并提高其睡眠质量.

目的 了解幼儿尿不湿(DD)依赖的临床特征和治疗效果.方法 本研究收集2019年6月至2020年10月在郑州大学第一附属医院和深圳儿童医院门诊就诊的日间DD依赖(DDD)幼儿86例(2～5岁)进行前瞻性随机分组治疗效果随访分析.幼儿分为治疗组和观察组,治疗组采用以如厕(排尿、排便)训练(T T)为主的治疗措施;观察组继续使用DD观察自然转归,分别在治疗3、6个月时随访治疗效果.治愈标准为日间能完全自主控制大小便.结果 DDD幼儿随机分为治疗组(36例)和观察组(50例).幼儿中有小便不能控制的30例,大便不能控制26例,大小便均无法控制的16例,14例伴有便秘情况.治疗后随访显示治疗组治愈率明显高于观察组,治疗组和观察组3个月时的治愈率为55.56％(20/36)v s.2.00％(1/50),P<0.05,6个月时为72.22％(26/36)v s.20.00％(10/50),P<0.05.治疗组剩余10例幼儿6个月时随访时9例均显示部分治愈,观察组剩余40例幼儿15例显示部分治愈,差异有统计学意义.结论 T T是治疗DDD相关的大小便不能控制的有效方法.2岁以前开始T T有利于预防DDD的发生.

Objective:To explore the risk factors and predictors of upper urinary tract injury in pediatric neurogenic bladder (PNB).Methods:Between 2013 and 2020, retrospective analysis was performed for clinical history, laboratory tests, imaging examinations and urodynamic results of 131 PNB children.No specific treatment was offered before hospitalization.They were divided into two groups of upper urinary tract injury and non-injury.The parameters of renal function and the results of imaging examination of urinary system were recorded.Multivariate Logistic stepwise regression analysis was employed for determining the risk factors of upper urinary tract injury.And receiver operating characteristic (ROC) curve was plotted for examining the clinical predictors of upper urinary tract injury.Results:There were 82 children with impaired urinary tract ((7.08±3.79) years, 37 boys/45 girls) and 49 with unimpaired urinary tract ((8.03±4.06) years, 27 boys/22 girls). Bladder volume ratio (BVR), maximum detrusor pressure during filling (maxPdet), compliance (△C), maximum flow rate (Qmax), bladder emptying efficiency (BVE), detrusor leak point pressure (DLPP), bladder wall thickness (BWT), uroleucocyte, lymphocyte ratio, neutrophilratio, lymphocyte count (LY) and the incidence of overactive bladder (OAB), detrusor sphincter dyssynergia (DSD), acontractile detrusor (ACD), "christmas-tree-shaped" bladder, bladder wall roughness, multiple diverticuliform changes, vesicoureteric reflux (VUR) and positive urinary culture were significantly different between two groups ( P<0.05). Multivariate Logistic stepwise regression analysis revealed that elevated DLPP ( OR: 1.223, 95% CI: 1.035-1.444), thickened BWT ( OR: 3.763, 95% CI: 1.347-10.551), lowered △C( OR: 0.760, 95% CI: 0.603-0.957) and lymphocytopenia ( OR: 0.507, 95% CI: 0.274-0.940) were risk factors.ROC curve revealed that BWT was an even better risk predictor of upper urinary tract injury (AUC=0.866, 95% CI: 0.800-0.933). The optimal cut-off value was 3.925 mm (sensitivity 0.854, specificity 0.776). Conclusion:Elevated DLPP, lowered △C, thickened BWT and reduced LY are risk factors for upper urinary tract injury.BWT has great values in predicting upper urinary tract injury in PNB.And BWT>3.925 mm may be adopted as a predictive critical value.

NLRP3 inflammasome has been implicated in impaired post-injury muscle healing and in muscle atrophy. Histamine receptors play an important role in inflammation, but the role of histamine H3 receptor (H3R) in myocyte regeneration and in the regulation of NLRP3 inflammasome is not known. We studied the effects of H3R signaling on C2C12 myocyte viability, apoptosis, and tumor necrosis factor alpha (TNFα)-induced NLRP3 inflammasome activation during striated myogenic differentiation at three time points (days 0, 3, and 6). Expression of Nlrp3, interleukin-1β (IL-1β), and myogenesis markers were determined. TNFα reduced overall viability of C2C12 cells, and exposure to TNFα induced apoptosis of cells at D6. Activation of H3R had no effect on viability or apoptosis, whereas inhibition of H3R increased TNFα-induced apoptosis. Stimulation of C2C12 cells with TNFα increased Nlrp3 mRNA expression at D3 and D6. Moreover, TNFα reduced the expression of myogenesis markers MyoD1, Myogenin, and Myosin-2 at D3 and D6. H3R attenuated TNFα-induced expression of Nlrp3 and further inhibited the myogenesis marker expression; while H3R -blockage enhanced the proinflammatory effects of TNFα and increased the myogenesis marker expression. TNFα-induced secretion of mature IL-1β was dependent on the activation of the NLRP3 inflammasome, as shown by the reduced secretion of mature IL-1β upon treatment of the cells with the small molecule inhibitor of the NLRP3 inflammasome (MCC950). The activation of H3R reduced TNFα-induced IL-1β secretion, while the H3R blockage had an opposite effect. In conclusion, the modulation of H3R activity regulates the effects of TNFα on C2C12 myocyte differentiation and TNFα-induced activation of NLRP3 inflammasome. Thus, H3R signaling may represent a novel target for limiting postinjury muscle inflammation and muscle atrophy.

目的 调查婴幼儿(<36个月)和学龄前儿童(3～6岁)在婴幼儿阶段(<36个月)的尿不湿(disposable diapers,DD)使用情况,并分析DD使用情况对排尿控制的影响.方法 于2017年3月至2017年9月在郑州市、洛阳市、开封市、运城市、深圳市、厦门市对9540例0～6岁汉族儿童及其家长进行调查,调查采用不记名问卷的形式,并按儿童年龄分组(<36个月儿童归入组1,3～6岁儿童归入组2)后对结果进行整理.采用SPSS 21.0进行统计学分析,比较两组间DD使用率、排尿训练率及其变化趋势,分析影响儿童排尿控制的因素.结果 问卷实际回收率为86.84％(8285/9540).组1中现在或曾经用过DD的人数占93.16％(2369/2543),组2中3岁前有90.60％(5202/5742)的人曾使用过DD,差异具有统计学意义(P<0.05);在组2中,3岁时能做到日间排尿控制的人数在使用和未使用DD的儿童中占比分别为85.41％(503/540)和93.07％(4442/5202),差异有统计学意义(P<0.05);进行排尿训练和未进行排尿训练的儿童能做到日间排尿控制比例分别为86.76％(4705/5423)和75.24％(240/319),差异有统计学意义(P<0.05).Logistic回归分析显示,使用DD是导致日间排尿控制不佳的危险因素,而进行排尿训练是日间排尿控制的保护因素.组1中2岁后接受排尿训练比例为14.02％(174/1241),明显高于组2的4.98％(286/5742);18月龄之前未接受排尿训练的比例为19.49％(319/1637),明显高于组2的8.86％(509/5742);二者差异均有统计学意义(P<0.05).结论 尿不湿的使用会延长婴幼儿日间控尿的发育时间,不利于儿童的成长发育,社会应当更加重视宣传合理使用尿不湿,并尽早开展排尿训练.

Objective To investigate the clinical significance of immune-related long non-coding RNAs (lncRNAs) and their potential role in guiding the treatment of prostate cancer. Methods lncRNAs of prostate cancer were obtained from TCGA database. The immune-related gene sets were downloaded from Molecular Signatures Database. Gene-lncRNA co-expression was confirmed by Pearson correlation analysis, and univariate Cox regression and selected operator regression (Lasso) were performed to identify important and immune-related lncRNAs. "gglot package" and "survival package" of R software were used to evaluate the correlation between the lncRNAs and clinical characteristics and the prognostic value of the lncRNAs. lnc2RNA database was used to analyze the difference of lncRNAs between normal prostate tissue and prostate cancer tissue. Starbase and David database were used to determine the predict function of lncRNAs in prostate cancer. Results AL162586.1, AC138028.4, SLC25A25-AS1, AC002553.1, AC004816.1, LINC00641 and AC027796.4 were key immune-related lncRNAs, and their expression was positively associated with N stage; the expression levels of AL162586.1 and SLC25A25-AS1 increased with higher T stage. The expression levels of SLC25A25-AS1 and LINC00641 were significantly different in tumor tissues from that of normal tissues. The GO enrichment showed that SLC25A25-AS1 was mainly distributed in membrane, had negative regulation of mRNA splicing via spliceosome and by a nucleotide binding. KEGG pathway enrichment showed that targeted genes were mainly involved in spliceosome pathway. Conclusion lncRNA has become a new research direction in prostate cancer and SLC25A25-AS1 may affect the prognosis of patients through splicing pathway.

To determine the prevalence of bladder and bowel dysfunction (BBD) and its relationship with delayed elimination communication (EC) in children. A cross-sectional study was carried out in kindergartens and primary schools in mainland China. A total of 10,166 children ranging from 4 to 10 years old were included. A total of 10,166 valid questionnaires were collected, and 409 children were diagnosed with BBD. The overall prevalence was 4.02% (409/10,166) and decreased with age, from 6.19% at age 4 to 1.96% at age 10. With the prolonged use of disposable diapers (DDs), the commencement of usage of EC in a child was significantly put off or delayed by parents, and the prevalence of BBD amongst these children increased (P < 0.001). The prevalence of BBD among children who stopped using DDs within the first 12 months and after more than 24 months was 2.79% and 4.38% respectively. Additionally, the prevalence among children who started EC within 12 months after birth and those who never engaged in EC was 1.36% and 15.71% respectively. Early introduction of EC and weaning of DD usage has a positive correlation with lower prevalence of BBD in children in China.

Objective:To investigate the urodynamic characteristics in Parkinson's disease(PD)versus multiple system atrophy(MSA)patients with lower urinary tract symptoms(LUTS).Methods:We performed a retrospective study in PD and MSA patients admitted to the First Affiliated Hospital of Zhengzhou University and undergone urodynamic examinations from January 2016 to June 2019.A total of 178 patients, mean age(59.2±9.7)years were enrolled, with 64 PD patients, 74 MSA patients and 40 normal controls.Urodynamic parameters included maximum flow rate(Qmax), post-voided residual urine volume(PVR), bladder compliance(BC), overactive bladder(OAB), maximum cystometric capacity(MCC)and detrusor pressure at maximum flow rate(PdetQmax). Bladder function was assessed.Results:Frequent urination(68.8%)was the most common LUTS in PD patients, as opposed to urinary retention(91.9%)in MSA patients.The Qmax, PdetQmax and incidence of OAB were higher and the PVR were lower in PD patients than in MSA patients [free-flow(FF)-Qmax: (13.5±7.1)ml/s vs.(10.1±5.2)ml/s, U=26.98, P<0.01]; pressure-flow study(PFS)-Qmax: [(13.6±5.7)ml/s vs.(10.5±3.3)ml/s, U=34.90, P<0.01]; PFS-PdetQmax: [(23.9±11.3)cm H 2O vs.(16.3±8.6)cmH 2O, U=35.04, P<0.01]; OAB: (46.9% vs.27.0%, χ2=5.85, P<0.01); FF-PVR: [(30.4±20.0)ml vs.(161.7±79.8)ml, U=-71.81, P<0.01]; PFS-PVR: [(65.9±30.7)ml vs.(212.6±83.0)ml, U=-65.29, P<0.01]. Compared with the control group, the incidences of OAB and PFS-PVR were increased and the MCC and PdetQmax were decreased in the PD group(OAB: 46.9% vs.7.5%, χ2=6.15, P<0.018); PFS-PVR: [(65.9±30.7)ml vs.(22.2±10.4)ml, U=47.25, P<0.01]; MCC: [(305.1±79.7)ml vs.(389.6±65.2)ml, U=-52.13, P<0.01]; PdetQmax: [(23.9±11.3)cmH 2O vs.(37.3±10.3)cmH 2O, U=-49.88, P<0.01]. Compared also with the control group, the MSA group had a lower Qmax, PdetQmax and MCC, FF-Qmax: [(10.1±5.2)ml/s vs.(16.3±4.7)ml/s, U=-50.11, P<0.01]; PFS-Qmax: [(10.5±3.3)ml/s vs.(13.1±5.0)ml/s, U=-27.54, P<0.05]; PdetQmax: [(16.3±8.6)cmH 2O vs.(37.3±10.3)cmH 2O, U=-84.92, P<0.01]; MCC: [(284.3±71.8)ml vs.(389.6±65.2)ml, U=-39.31, P<0.01], a higher PVR, lower bladder compliance(BC)and a higher incidence of OAB(FF-PVR: [(161.7±79.8)ml vs.(22.0±13.0)ml, U=84.82, P<0.01]; PFS-PVR: [(212.6±83.0)ml vs.(22.2±10.4)ml, U=112.54, P<0.01]; BC: (28.4% vs.7.5%, χ2=6.81, P<0.01); OAB: (27.0% vs.7.5%, χ2=17.62, P<0.01). Conclusions:PD and MSA patients with LUTS have bladder dysfunction.MSA patients have more serious bladder dysfunction than PD patients.

目的 通过TCGA(癌症基因组图谱)数据库确定与宫颈癌预后相关的免疫相关性LncRNA,并基于确定的免疫相关性LncRNA构建宫颈癌预后模型.方法 从TCGA数据库中下载宫颈癌转录组及临床数据,从Molecular Signatures Database下载免疫相关基因,利用Strawberry Perl软件和R软件对数据进行处理和分析.首先构建免疫基因-LncRNA共表达网络,筛选免疫相关性LncRNA.通过单因素COX回归筛选出影响宫颈癌预后的免疫相关性LncRNA.再通过多因素COX回归分析构建预后模型.根据风险评分的中位数将患者分为高风险组和低风险组,运用Kaplan-Meier(K-M)生存分析、受试者接受特征(receiver operating characteristic,ROC)曲线对模型进行评价和验证.将得到的关键LncRNA与宫颈癌临床特征进行相关性分析.结果 通过免疫基因-LncRNA共表达网络,筛选出637个免疫相关性LncRNA,利用单因素COX回归筛选出34个与预后相关的免疫相关性LncRNA,基于多因素COX回归和AIC值确定构成最优模型的8个关键的免疫相关性LncRNA(AC004540.2、AL365203.2、ATP2A1-AS1、AC096992.2、AC004847.1、AC097468.3、AC099568.2、AC105277.1).通过多因素COX回归分析构建预后模型,将高低风险组患者进行K-M生存分析显示高风险组生存率显著低于低风险组.ROC曲线下面积为0.758.将8个关键LncRNA与临床特征进行相关性分析可见AC099568.2、AC105277.1与T分期具有相关性(P<0.05),其表达量随着T分期增加逐渐降低,提示其可能为宫颈癌预后的保护因素.结论 通过生物信息学分析,成功构建了基于此8个LncRNA表达水平的宫颈癌预后模型,确定了8个关键的与宫颈癌预后相关的免疫相关性LncRNA,有望成为宫颈癌的潜在治疗靶点.其中AC099568.2和AC105277.1可能在宫颈癌的预后中有保护作用.

目的 了解一次性尿布的使用和排尿训练(elimination communication,EC)对2～3岁幼儿日间尿失禁(daytime urinary incontinence,DUI)的影响.方法 使用自制问卷对2297名2～3岁幼儿的家长进行调查,内容包括一次性尿布的使用、EC开始时间和DUI情况等.结果 2～3岁幼儿总体DUI的发生率为8.45％(194/2297).一次性尿布使用时间越长,进行排尿训练的人数比例越低(χ2=10.086,P=0.001),DUI的发生率越高(χ2=11.166,P<0.001).随着EC开始时间的延迟,DUI的发生率逐渐增高(χ2=13.760,P<0.001).Logistics回归分析结果显示,一次性尿布使用时间延长是2～3岁幼儿DUI的危险因素,12个月龄之前开始排尿训练是2～3岁幼儿日间排尿控制的保护因素.结论 一次性尿布使用时间延长和EC延迟是2～3岁幼儿日间排尿控制的危险因素,12个月龄以前开始排尿训练有助于降低幼儿DUI的发生率,并使其尽早获得日间排尿控制.

Aims To investigate the prevalence of overactive bladder (OAB) and assess its risk factors in 5- to 14-year-old Chinese children. Methods A cross-sectional study of OAB prevalence was performed by distributing 11 800 anonymous self-administered questionnaires to parents in five provinces of mainland China from July to October 2018. The questionnaires included questions on sociodemographics, history of urinary tract infection (UTI), lower urinary tract symptoms (LUTS), family history of LUTS, bowel symptoms, and details about the elimination communication (EC) start time. OAB was defined as urgency and increased the daytime frequency with or without urinary incontinence. Results A total of 10 133 questionnaires qualified for statistical analysis. The overall prevalence of OAB was 9.01% and decreased with age, from 12.40% at 5 years to 4.55% at 14 years (chi(2)trend = 88.899; P < .001). The proportion of dry OAB increased with age, whereas the proportion of wet OAB decreased. A late-onset of EC was associated with a high OAB prevalence (chi(2) trend = 39.802; P < .001). Children with obesity, a history of UTI, nocturnal enuresis (NE), a family history of LUTS, constipation, and fecal incontinence had a higher prevalence of OAB than did normal children (P < .05). Conclusion Obesity, a history of UTI, NE, a family history of LUTS, and bowel symptoms are risk factors associated with OAB. Starting EC before 12 months of age might help reduce the prevalence of OAB in children.

Aims A pilot survey shows that primary nocturnal enuresis (PNE) prevalence has increased significantly during the past decade in Mainland China. Whether it is related to the delay of elimination communication (EC) is unclear. This study retrospectively investigated the influence of delayed EC on the PNE prevalence in children and adolescents in mainland China. Methods A cross-sectional study of PNE prevalence was performed by distributing 19 500 anonymous self-administered questionnaires to parents in five provinces of mainland China from July 2017 to October 2017. The questionnaires included sociodemographic data, family caregivers' information, and details about the disposable diapers (DD) usage, EC commencement date, psychological disorders, lower urinary tract symptoms, and family history of PNE in children and adolescents. The 2017 PNE prevalence was compared with that of 2006 in Mainland China. Results The total response rate was 97.04% (18 631 of 19 500) and 92.39% (18 016 of 19 500) qualified for statistical analysis. The PNE prevalence in 2017 has increased significantly compared to that of 2006 (7.30% vs 4.07%, P < 0.001). The PNE prevalence in children with EC starting before 6 months of age was significantly lower than those who start after 12 months of age. The longer DD were used and the later the beginning of EC, the higher the PNE prevalence was found. Conclusions The PNE prevalence in Mainland China has increased significantly during the past 10 years. A longer use of DD and later onset of EC may be risk factors for PNE.

目的 探索行Snodgrass术治疗冠状沟型尿道下裂手术前后尿流率联合残余尿检查的临床意义.方法 分析2012年1月至2016年12月间98例行Snodgrass术的冠状沟型尿道下裂患儿手术前后尿流率及残余尿量,比较术前和术后差异.尿流率测定仪纪录尿流曲线、最大尿流率、平均尿流率、排尿量、排尿时间、最大尿流时间;超声测量膀胱残余尿量并检查膀胱及上尿路形态.结果 所有冠状沟型尿道下裂患儿超声检查均未发现膀胱和上尿路形态学异常.所有冠状沟型尿道下裂不同年龄段患儿术前、术后Qmax较正常儿童低.其中狭窄组26例、无狭窄组72例,狭窄组患儿术后3个月最大尿流率、平均尿流率、排尿时间、最大尿流时间、排尿量和残余尿量分别为(7.18±1.96)mL/s、(5.28±2.07)mL/s、(31.72±29.57)s、(15.88±11.94)s、(139.03±77.50)mL、(19.26±18.84)mL;而无尿道狭窄组相应各值分别为(8.09±3.39)mL/s、(6.45±2.02)mL/s、(29.05±11.59)s、(9.31±6.76)s、(133.87±64.11)mL、(16.42±14.31)mL.狭窄组最大尿流率、平均尿流率小于无狭窄组,而排尿时间最大尿流时间长于无狭窄组,其差异均有统计学意义(P<0.05).狭窄组术后3个月钟形曲线占11.5％,平台曲线占65.4％;而无狭窄组分别为26.3％、45.8％,其差异也有统计学意义(P<0.05).同时发现患儿术后6个月复查时结果与3个月时类似,而术后2周的狭窄组与非狭窄组结果之间并无明显差异.但值得注意的是术后2周、3、6个月所有患儿各项指标呈逐渐恢复趋势.结论 Snodgrass术治疗尿道下裂术后尿流率联合残余尿检查有利于发现术后尿道狭窄,尤其手术后3个月内复查更有意义.

Objective To explore the effect of using disposable diaper (DD) on the prevalence of pediatric bladder and bowel dysfunction (BBD ) and analyze the relevant-factors .Methods From March 2017 to September 2017 ,37 primary schools and kindergartens were randomly selected from the municipalities of Shenzhen , Xiamen and Zhengzhou . An anonymous epidemiological survey of using DD from birth and status of voiding and defecation was conducted for 8950 children aged 2 to 8 years .The number of surveyed students was over 200 at each institution .A retrospective survey was conducted by parents recalling past events and filling out questionnaires .For ensuring the accuracy of questionnaires ,the investigators were specially pre-trained .The main contents of questionnaire include general profiles ,whether using DD from birth ,age of stopped using DD ,duration of daily use (fullday or night-only use) , start time of elimination communication (EC) (including potting training , assistant infant's toilet training ) , whether current status of voiding and defecation fulfilling the diagnostic criteria for BBD and presence or absence of organic diseases affecting voiding and defecation .Results A total of 8026 valid questionnaires were collected and analyzed . Statistical analysis of t-test and chi-square test indicated that the overall prevalence of BBD in children surveyed was 2 .73％ and the prevalence of BBD declined with advancing age from 4 .89％ at age 2 to 0 .85％ at age 8 (P< 0 .001) .With the delayed use of disposable diapers and the prolonged daily use of DD ,the prevalence of BBD showed a rising trend (P< 0 .05) .The prevalence of BBD children stopping using DD within the first 6 months of birth was 0 .95％ and the prevalence of BBD in children stopped using DD after an age of 2 years was 6 .11％ .With a delayed start of elimination communication (EC) ,the prevalence of BBD gradually increased ( P < 0 .001 ) . The prevalence of BBD in children starting elimination communication (EC) within 6 months of birth was 0 .91％ and elimination communication (EC) began after an age of 2 years .The prevalence of childhood BBD was 6 .47％ .The multivariate logistic regression analysis of prevalence of BBD revealed that age of stopping using DD ,whole-day use of DD and obesity were risk factors for an onset of childhood BBD (OR > 1 , P< 0 .05) .Starting toilet training within 6 months was a protective factor for childhood BBD (OR < 1 ,P< 0 .05) .Conclusions Rational usage of DD and early start of EC are effective for preventing BBD in children .

目的 了解农村儿童与城市儿童的夜遗尿(nocturnal enuresis,NE)患病率及尿不湿使用率和排尿训练对遗尿的影响.方法 2017年6月至2017年12月,作者随机选取河南省5个地级市的市区及其所辖农村小学及幼儿园5～12岁儿童进行NE患病率、尿不湿使用情况和排尿训练情况调查,共发放问卷3141份,其中回收有效问卷2773份,有效回收率为88.28％,问卷来自农村儿童1201例,城市儿童1572例.结果 农村及城市5～12岁儿童NE患病率分别为4.33％和9.29％,差异有统计学意义(χ2=25.240,P<0.001);尿不湿使用率分别为76.44％和89.31％,差异有统计学意义(χ2=81.949,P<0.001);进行排尿训练的比例分别为95.75％和80.22％,差异有统计学意义(χ2=143.440,P<0.001).单因素分析发现,年龄、来源地、是否使用尿不湿、是否进行排尿训练是影响儿童发生NE危险因素(P<0.05).多因素分析显示,来源地(OR=26.949,95％CI:13.402～54.188)、不进行排尿训(OR=66.302,95％CI:34.020～129.217)是儿童NE的独立危险因素;年龄、性别和是否使用尿不湿尚没有发现与儿童NE存在关系.结论 农村儿童NE患病率比城市儿童低,进行排尿训练的儿童NE患病率低,加强排尿训练有助于减少儿童NE的发生.

Objective To explore the effects of histamine H3 receptor on inflammatory response during C2C12 striated myogenesis induced by exogenous alpha-tumor necrosis factor (TNF-α) and elucidate the resistant mechanism of exogenous inflammatory stimulation in pediatric urinary sphincter during development and repair process from a molecular prospective .Methods TNF-αstimulated C2C12 cells under striated myogenesis (D0/D3/D6) for mimicing exogenous inflammatory stimulation in pediatric urinary sphincter during development and repair process .Cell count kit-8 (CCK 8) method and flow cytometry (FCM) were utilized for detecting cell growth and apoptosis induced by TNF-α, and histamine H3 receptor agonist methimepip (Met ) and antagonist cirpoxifan (CPX ) . The inflammatory marker NLRP3 and three differentiation markers (early , middle & late ) MyoD1 , myogenin and myosin-2 were detected by real-time quantitative polymerase chain reaction (Q-PCR) . The secretion of interleukin-1 beta (IL-1b) was detected by enzyme-linked immunosorbent assay (ELISA) .Results During C2C12 myogenesis ,TNF-αand NF-α+ CXP inhibited cell growth by CCK-8 (P<0 .05) while TNF-α+Met did not (P>0 .05) .TNF-αand TNF-α+ Met did not induce apoptosis or necrosis while TNF-α+ CXP induced 29 .9％ apoptosis and 31 .4％ necrosis of D6 cell . The mRNA expression of NLRP3 increased 101％ vs .90％ by TNF-αin D3 and D6 respectively ;Met reduced the NLRP3 mRNA induced by TNF-αas 33％ vs .37％ , while CPX increased NLRP-3 mRNA induced by TNF-αas 23％ vs .24％ .TNF-αreduced the expression of myogenesis marker MyoD1 mRNA in D3 and D6 by 45％ and 43％ ,Myogenin mRNA by 29％ vs .35％ and Myosin-2 mRNA by 42％ vs .33％ respectively ;Met decreased the TNF-α-reduced differentiation marker mRNA again by 23％ vs .31％ ,23％ vs .26％ ,31％ vs .36％ ;while CPX increased the TNF-α-reduced differentiation marker mRNA by 40％ vs . 25％ , 35％ vs . 31％ , 50％ vs . 21％ . The secretion of IL-1 bwas 49 .7 pmol/ml by TNF-αon D6 cells and Met decreased the IL-1 bsecretion by TNF-αat 37 .9 nmol/L (T=12 .5 ,P<0 .001) while CPX increased the IL-1 bsecretion by TNF-αat 64 .4 nmol/L (T=29 .5 , P<0 .001) .Conclusions TNF-αcan induce inflammatory response during C2C12 striated myogenesis and also inhibit this differentiation process while histamine H 3 receptor can inhibit the inflammatory response induced by TNF-αand control to reduce the differentiation process . So when exogenous inflammatory stimulation affects urinary sphincter during the development and postoperative repair process , activating H3 receptor may antagonize the effects of exogenous inflammatory stimulus and maintain normal cellular development and repair process .