Objective To explore the methods and clinical application of percutaneous pediculoplasty in the treatment of vertebral pedicular osteolytic metastases.Methods Percutaneous pediculoplasty was performed in 18 patients with (23 Vertebral pedicles ) osteolytic metastases,3 cases localized in thoracic vertebral pedicles and 15 cases in lumbar vertebral pedicles,and two vertebral pedicles involved in 5 cases . Under Multislice helical CT guidance ,2.5～5ml of polymethylmethacrylate ( PMMA ) mixture (ratio of polymer,moner,ultrafluid iodinated oil was 20g:10ml:3ml) was injected into pathologic pedicles in step by step after successful puncture using 11-13G needles. All cases had been followed for 1～18 months.Results All cases were successful punctured. Pain relieved in all cases after percutaneous pediculoplasty.7 cases had cement leakage,among them,cement leaked into tumor tissue in 5 cases(2 cases with leakage into intervertebral foremen),nerve radicular pain occurred in one case,the pain disappeared 3 days later after intravenous mannitol and lower dose dexamethasone drips;the cement leaked into vertebral canal a little without clinical symptom in one case.Conclusion CT-guided percutaneous pediculoplasty is a minimally effective and safe method for osteolytic vertebral pedicular metastases in treatment of pain and enhancement of spinal stability.

Objective To explore the diagnosis and treatment of female bladder outlet obstruction (BOO) with bladder pain as major symptom.Methods From November 2008 to December 2012,21 female patients suffered from urinary frequency,urgency,pain in suprapubic area during bladder filling phase were enrolled in the study.Video-urodynamics (VUD) study combined with free urinary flow rate andresidual urine were performed in all patients in order to make the diagnosis of BOO clearly.The mean maximum urinary flow rate was (11.5±3.6) ml/s,and the mean maximal detrusor pressure was (39.1±17.8) cmH2O.Combining with the voiding radiography,19 patients were diagnosed as bladder neck obstruction,and the other 2 were diagnosed as urethral stricture.All patients were accepted the hydrodistension under the epidural anesthesia.The bladder biopsy was performed if the typical glomerulations were observed under the cystoscopy.Bladder neck incision and urethral dilatation were performed on these patients respectively.Symptom changes of bladder pain were recorded by using O'Leary-Sant scale,the pain,urgency,frequency symptom (PUF) scale and quality of Life (QOL) Scale.The data were collected within 48 months postoperation,respectively.Results The pathological findings of bladder mucosa biopsy showed acute or chronic inflammation in all patients.The mean follow-up was 6.7±5.9 months.We compared the corresponding data such as:voiding times per day,nocturnal frequency,O'Leary Sant scores,PUF and QOL between pre and post-treatment.Significant differences were observed during all corresponding data (P＜0.05).The voiding times per day changed from 24.3± 11.8 to 13.0±5.9.The nocturnal frequency decreased from 6.5±2.7 to 3.3± 1.6.O'Leary Sant scores changed from 24.6±7.3 to 14.7±7.4.The PUF scores changed from 22.9±6.2 to 12.0± 7.1.And the QOL scores changed from 5.0±0.8 to 2.9±1.5.Conclusions Free urinary flow rate and residual urine combined with VUD are very important in diagnosing female BOO with bladder pain as major symptom.Bladder pain symptoms will be significantly improved after the obstruction was relieved according to VUD results.

OBJECTIVE:To prepare aspirin phospholipid complex (ASP-PC) and conduct the characterization. METHODS:Using the combination rate of ASP and PC as index,single factor test was used to screen the preparation method of ASP-PC,PC type,solvent type,reaction time,reaction temperature,solvent volume and drug-lipid ratio. The verification test was conducted. UV spectrophotometry,Thermogravimetric analysis,X-ray diffraction and Fourier transform infrared spectroscopy were used for the characterization of ASP-PC. RESULTS:Magnetic stirring-condensing reflux method was adopted,drug-soybean phospholipids ratio was 1:3 (mol/mol),solvent was tetrahydrofuran,reacting for 3 h under 58 ℃. The average combination rate of prepared ASP-PC was 83.52％(RSD=1.16％,n=3). Compared with ASP,physical mixture of ASP and PC,UV spectrum showed that ASP-PC had no new absorption peak. Thermogravimetric analysis,X-ray diffraction and Fourier transform infrared spectroscopy showed the ASP and PC in ASP-PC were interacted;and ASP-PC changed little in quality within 0-300 ℃. CONCLUSIONS:ASP-PC can be successfully prepared,in which,ASP and PC were combined successfully;while there are still trace amounts of ASP in the form of crystals.

BACKGROUNDTo investigate the indication, complication and efficacy of bronchial artery embolization for the management of lung cancer with massive hemoptysis.

METHODSThirty-eight cases of lung cancer with massive hemoptysis were retrospectively analyzed in our hospital from January 1996 to January 2003. All cases presented with acute hemoptysis from 220 to 980 ml daily, with a mean of 290 ml daily. A digital subtracted bronchial arteriogram was perfomed and bleeding arteries were embolized.

RESULTSHemoptysis decreased gradually in all cases and ceased in 3 or 4 days after embolization. Recurrence was found only in one case 2 months after embolization and second embolization was applied to control hemoptysis. No serious complications occured.

CONCLUSIONSBronchial artery embolization is safe and efficient for the management of lung cancer with massive hemoptysis.

Purpose: Elder self-neglect is a global public health issue and should be taken seriously at large. Nurses,usually working directly with elderly patients, have a better understanding of what factors may causeelder self-neglect. In this qualitative study, we explored the influencing factors of elder self-neglect fromthe perception of nurses in the context of Chinese culture. Methods: Face-to-face, in-depth interviews were conducted from November 2018 to December 2018.Purposive sampling was used. Twenty one participants recruited from eight geriatric wards of a generalhospital located in Wuhan were interviewed. A content analysis of qualitative nature was performed toanalyze the data. Results: Our conceptual model illustrated the findings based on the three themes of the conflict betweenpersonal recognition and social judgment, the choice between current needs and individual beliefs, aswell as the compromise between insufficient abilities and limited resources. Conclusion Nurses together with family members and social workers can help older adults improvetheir awareness of self-neglect to bridge the gap with social judgment, learn to focus on their own needs,as well as seek as much support as possible. Nurses should also respect the autonomy and selfdeterminationof elder self-neglecters because self-neglect is related to older adults' values. Furthermore,larger studies are needed to quantitatively test and refine the model.

Purpose: Elder self-neglect is a global public health issue and should be taken seriously at large. Nurses,usually working directly with elderly patients, have a better understanding of what factors may causeelder self-neglect. In this qualitative study, we explored the influencing factors of elder self-neglect fromthe perception of nurses in the context of Chinese culture. Methods: Face-to-face, in-depth interviews were conducted from November 2018 to December 2018.Purposive sampling was used. Twenty one participants recruited from eight geriatric wards of a generalhospital located in Wuhan were interviewed. A content analysis of qualitative nature was performed toanalyze the data. Results: Our conceptual model illustrated the findings based on the three themes of the conflict betweenpersonal recognition and social judgment, the choice between current needs and individual beliefs, aswell as the compromise between insufficient abilities and limited resources. Conclusion Nurses together with family members and social workers can help older adults improvetheir awareness of self-neglect to bridge the gap with social judgment, learn to focus on their own needs,as well as seek as much support as possible. Nurses should also respect the autonomy and selfdeterminationof elder self-neglecters because self-neglect is related to older adults' values. Furthermore,larger studies are needed to quantitatively test and refine the model.

Objective:To investigate the clinicopathological and genetic features of epithelioid and spindle cell rhabdomysarcoma with EWSR1-TFCP2 or FUS-TFCP2 fusion.Methods:The clinical, morphological and immunohistochemical features of 14 cases of epithelioid and spindle cell rhabdomysarcoma with EWSR1-TFCP2 or FUS-TFCP2 fusion diagnosed from January 2019 to December 2022 in the Department of Pathology, Foshan Traditional Chinese Medicine Hospital, Foshan, China were retrospectively analyzed. The cases were all subject to FISH or next generation sequencing for analysis of molecular genetic features. The literature was reviewed.Results:There were 5 males and 9 females, with the age at presentation ranging from 6 to 36 years (mean, 22 years). Tumors occurred in the head and neck (9 cases), pelvic region (2 cases), bladder (one case), right humerus (one case), and the abdominal wall, humerus and pubic at the same time (one case). Presenting symptoms varied by location but often included pain or discomfort. Most of the patients showed aggressive radiographic features with soft tissue extension. The tumors had a median size of 6.6 cm (range, 2-23 cm). The tumors were poorly defined and irregularly shaped. Microscopic examination showed diffuse proliferation of spindle or epithelioid cells. While morphologically high-grade tumors displayed obvious cytological atypia, a high mitotic count and tumor necrosis, low-grade tumors grew in sheets and fascicles composed of spindle, epithelioid cells with moderate or abundant amounts of eosinophilic cytoplasm, without pronounced cytological atypia. The tumor cells expressed Desmin, MyoD1, and Myogenin, as well as ALK, EMA, and CKpan. EWSR1/FUS-TFCP2 gene fusion was detected in 14 cases with next generation sequencing and confirmed by FISH. Six cases had EWSR1-TFCP2 fusions and 8 cases showed FUS-TFCP2 fusions. Follow-up information was available in 13 patients, ranged from 5 to 37 months. At the end of follow-up period, 7 patients died of the disease. Six patients were alive:two cases had local recurrences and metastases, two cases of recurrences, one case of metastasis and one case without recurrences and metastasis.Conclusions:Epithelioid and spindle cell rhabdomysarcomas with EWSR1-TFCP2 or FUS-TFCP2 fusion show a very aggressive clinical course, and more commonly occur in the head and neck. Their genetic hallmark is the presence of EWSR1/FUS-TFCP2 fusions. Familiarity with its clinicopathological characteristics is helpful in avoiding misdiagnoses.

Objective To summarize the initial treatment experiences of SNM on non-neurogenic,non-obstructive dysuria during short follow-up.Methods From January 2013 to May,2017,28 patients with non-neurogenic,non-obstructive dysuria who were diagnosed by video-urodynamic study (including 20 male patients and 8 female patients;17 patients suffered from urethra sphincter spasm and 11 from idiopathic detrusor weakness) were recruited in our study.All of them received ⅠnterStim sacral neuromodulation treatment.We tried to compare the data (such as frequency in 24 hours,residual urine,dysuria degree,nocturia,average volume and urgency) before operation and the data of short term follow-up after stage Ⅱ implanted pulse generator (IPG) embedded in order to summarize the initial experiences of sacral neuromodulation for non-neurogenic,non-obstructive dysuria.Results All 28patients received stage Ⅰ operation with percutaneous approach to implant a tined lead,11 patients (8 male patients and 3 female patients) finally removed the tined lead because of poor testing effects.17 patients (12 male patients and 5 female patients) choose embedding IPG at the end of stage Ⅰ.Of all these patients,the conversion rate of stage Ⅰ to stage Ⅱ is 60.7％ (17/28),among them,the conversion rate of urethra sphincter spasm is 64.7％ (11/17) and the conversion rate of idiopathic detrusor weakness is 54.5％ (6/11).The follow-up time after stage Ⅱ was16.7 months (10-46 months).The data of voiding frequency in 24 hours,residual urine,dysuria degree,nocturia,urgency,average voiding amount and quality of life (QOL) between baseline (before stage Ⅰ) and at the follow-up time were 16.3 ± 6.1 vs.8.8 ± 4.1 (P =0.000),(43.0 ± 73.4) ml vs.(37.867.1)ml(P=0.178);7.8 ±2.3vs.4.3 ±1.2(P=0.001);4.0± 1.8 vs.2.5 ±1.7(P=0.003),3.1±1.7vs.1.9±1.1(P=0.001),(145.7 ±73.5)ml vs.(189.0±66.4)ml(P=0.48),5.7vs.1.4 (P ＜ 0.05) and 5.4 ± 0.7vs.4.0 ± 1.0 (P =0.000),respectively.During the follow-up period,11 patients satisfied with symptoms relieve without recurrence.Six patients had symptoms recurrence,4/6 patients regain the effects after reprogramming,but two patients remained serious recurrence even after repeated reprogramming(frequency,dysuria and hesitation recurred as before SNM).Conclusions SNM is an effective,safe and minimally invasive procedure for patients with non-neurogenic,non-obstructive dysuria.Primary,non-neurogenic urinary sphincter spasm is a good indication for SNM and had high transfer rate.

Objective:We compare the consistency, similarities and differences of operating procedures, data and conclusions of air-charged catheters(ACC) and water-filled catheters(WFC), as simultaneously using ACC and WFC in pressure-flow study(PFS).Methods:This study was a prospective, synchronously controlled study, including eligible patients who underwent PFS in the Department of Urology, Beijing Chaoyang Hospital from January 2021 to March 2021. Inclusion criteria: ① Patients need PFS for lower urinary tract symptoms like frequency of urination, urgent urination, urinary incontinence and dysuria; ② Age over 18 years old. Exclusion criteria: ① Unable to complete or cooperate during the urodynamic test; ② Patients with severe urethral stricture or acute stage urinary tract infection; ③ Pregnant women. The bladder pressure was measured continuously by using a 7FDR T-DOC ?AC three-chamber bladder pressure tube, which linked to ACC sensor and improved WFC pressure conduction module. At the same time, 7FA T-DOC ?AC single-lumen rectal pressure tube and 7F Labori-CAT411 double-lumen water sac abdominal pressure tube was used to measure the ACC and WFC rectum pressure, respectively. We recorded the Pdet, Pves and Pabd measured by ACC and WFC, at the point of initial sitting position, bladder filling at 100 ml, 150 ml, 200 ml, cough, Q max, maximum Pdet and the end of urination, and compared the mean values, differences, and consistencies of our data. Result:A total of 63 patients (26 female, 37 male) were included in this study, with an average age of 59.19 years (25-86 years old). During bladder filling phase, the mean values of Pves measured by ACC and WFC were 30.78/24.67cmH 2O (initial sitting position), 29.79/25.13cmH 2O (100 ml), 30.87/25.90cmH 2O (150 ml) and 30.95/26.17cmH 2O(200 ml), respectively, the mean value of Pabd were 30.03/24.17cmH 2O (initial sitting position), 28.81/21.78cmH 2O (100ml), 28.89/21.38cmH 2O (150ml), 28.44/21.60cmH 2O (200ml), respectively, and were significantly different at each sampling point ( P<0.01). During urination period, no significant differences were found in data( P>0.05), and the data measured with ACC and WFC system have good consistency. There were significant differences in Pves(mean 57.30/49.95 cmH 2O, respectively) and Pdet(mean 54.21/43.10 cmH 2O, respectively) between ACC and WFC in cough ( P<0.01), but there was a strong linear correlation between these data between two systems(R 2=0.792 in Pves and 0.756 in Pabd). Bland-Altman analysis showed that detrusor pressure at the maximum urine flow rate maintained good consistency between ACC and WFC, which 95% CI was -13.9 cmH 2O to 15.8 cmH 2O. Conclusions:In PFS, although the ACC measurement values (Pves and Pabd) during the filling phase are higher than those WFC readings, but the absolute measurement difference is small, so there is no practical meaning in clinical practice. There was no significant difference in detrusor pressure measured during voiding phase, which indicated that the urodynamic judgment and clinical conclusions of the two systems are highly consistent in judgment of the detrusor contractility and the bladder outlet obstruction.

Objective:To compare the clinical efficacy and safety of single incision mini slings (contasure needless, C-NDL) and tension-free vaginal tape obturator (TVT-O) in the treatment of pure female stress urinary incontinence(SUI).Methods:Clinical data of 107 female SUI patients who underwent C-NDL ( n=51) or TVT-O ( n=56) procedure during October 2013 and October 2017 in Department of Urology, Beijing Chaoyang Hosptial, Capital Medical University were enrolled.The age of the patients in the C-NDL and TVT-O group was (58.8±9.3) years (range: 43 to 81 years) vs.(56.9±11.4) years (range: 32 to 87 years), the cough leak point pressure was 70(20) cmH 2O ( M( Q R), 1 cmH 2O=0.098 kPa) vs. 80(25) cmH 2O. The pre- and peri-operative data, subjective cure rate, objective cure rate, quality of life, International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), Incontinence Impact Questionnaire-Short Form (IIQ-7) and other complications were compared. The t test, Wilcoxon rank sum test, analysis of variance, χ 2 test andFisher exact test were applied to compare the indexes. Results:In the C-NDL and TVT-O group, the median operation time was 30(10) minutes vs. 40(30) minutes ( Z=-3.73, P<0.01). The postoperative follow-up period was 32.0(17.4) months vs.41.0(23.2)months. At the latest follow-up, the objective cure rate was 48/51 vs. 54/56 (χ 2=0.01, P=0.94), the subjective cure rate was 43/51 vs. 50/56 (χ 2=0.03, P=0.86), ICIQ-SF was 2.29±4.02 (range:0 to 13) vs. 1.71±3.67 (range:0 to 18), and IIQ-7 was 1.12±1.85 (range: 0 to 7) vs.0.70±1.70 (range: 0 to 6). The statistically significant difference in the postoperative visual pain analogue scale (VAS) were found between the two groups (0(1.5) vs.1.0(1.0), Z=3.41, P<0.01). Dysuria occurred in 2 patients in each group, vaginal pain occurred in 1 patient in the C-NDL group, groin pain occurred in 2 patients and urinary urgency occurred in 3 patients in the TVT-O group too. There were no significant difference between the complication rates of the 2 group (3/51 vs.7/51, P=0.325). Conclusion:Both C-NDL and TVT-O may be effective and reliable in the treatment of female SUI.