This paper reports nursing of 11 patients undergoing laparoscopic radical cystectomy with orthotopic ileal neobladder. The nursing points included preoperative bowel care,psychological care,observation of drainage tubes and complications,guidance of pelvic floor muscle training and bladder training with timed voiding. Patients receiving bladder training after catheter removal,and got self-control urination in 2 weeks. Only a patient left urinary incontinence at night occasionally.

Cataract and age-related macular degeneration (AMD) often present concurrently in aged persons. There has been a longstanding controversy among clinicians as to whether cataract surgery is contraindicated in eyes with AMD. Most of previous researches indicated that cataract surgery could accelerate the progression of AMD. However recently studies suggested that cataract surgery improved visual function of the patients and didn't accelerate the progression of AMD. These are related to the development of cataract surgery and the using of phacoemulsification technique.

Next-generation sequencing (NGS) platforms have recently evolved to provide an accurate and comprehensive means for the detection of molecular mutations in acute myeloid leukemia(AML).The 54th ASH annal meeting reported lots of studies on NGS in AML,reflect the important role of the NGS technology in modern diagnosis and treatment of blood diseases and the impact on the future development of the blood disease.

TIMI Flow as a method to assess myocardial reperfusion has been employed clinically ever since 1980's.TIMI Frame Count grading is a more objective,repeatable and correlative in variablity than those of TIMI Flow.TMBG and TMP provide the reperfusion evaluation on myocardial microvascular level.Doppler contrast echocardiography could be used as an additional index to assess vessel recanalization and myocardial reperfusion.Moreover,MCE,continuous ECG monitoring of ST-segment,isotope imaging of myocardial reperfusion and myocardial-enhanced MRI can all be used as non-invasive evaluating approaches with great clinical value.(J Intervent Radiol,2006,15:250-253)

Objective To establish the determination of Dehydroandrographolide in Ganmaoqing Capsule. MethodsThe determination was carried out by HPLC with a KromasilC-18 column(250 mm ×4.6 mm,5μm),methanol-water(65:35)severed as the mobile phase,the speed was 1mL/min and the detection wavelength was at 254 nm. ResultsDehydroandrographolide showed a good linear relationship at the range of 0.04872 μg ～0.38976 μg(r2 =0.9995,n= 8);The average recovery of Dehydroandrographolide was 100.1%(RSD= 2.92%). ConclusionHPLC method was sensitive,accurate,reproducible,specific and could be used for quality control of Ganmaoqing Capsule efficiently.

Objectvi e To investigate whether promoting gap junctions may contribute to the radiosensi-tivity in triple negative breast cancer( TNBC)cells.Methods HCC70(triple-negative),MCF-7(ER-posi-tive)or SK-BR3(HER2-positive )cells were transfected with pcDNA/5 -Cx43 expression plasmid using liposome 2000.The transfected cells were treated with various doses of radiation(0,5,10,15 Gy),and the level of Cx43 protein was determined by Western blot and the cell connectivity was determined by fluorescent tracer technique. Cell proliferation inhibition,clone formation ability and apoptosis were detected using MTT,clone formation assay, AnnexinV-FITC/PI double staining and flow cytometer,respectively.Results The level of Cx43 protein signifi-cantly increased in HCC 70 -Cx43 ,MCF-7 -Cx43 and SK-BR3 -Cx43 cells.After transfection the cells were treated with various doses of radiation,level of Cx43protein was gradually enhanced in dose dependent fashion .The re-sults form fluorescent tracer technique showed that fluorescence intensity was gradually elevated with increase of radiation doses.Cell viability and clone formation ability were decreased gradually in dose dependent manner in HCC70-Cx43 ,MCF-7 -Cx43 and SK-BR3-Cx 43 cells.Unexpectedly,the inhibitive effect of proliferation ability and clone formation ability in HCC70 -Cx43 cell was higher than in MCF-7 -Cx43 and SK-BR3 -Cx43 cells under same conditions.The results from AnnexinV-FITC/PI and flow cytometer showed that apoptosis rate was enhanced gradually accompanying with increase of radiation doses.Conclu sion Enhancing the function of cell gap junc-tions promoted radiosensitivity of breast cancer cells,particularly in TNBC cells.Radiation can strengthen cell gap junctions in breast cancer cell and cytotoxicity of TNBC cell can be enhanced by both synergistic effects.

Objective To compare the sensitivity and specificity of NMP 22 test with voided urine cytology in detection of bladder cancer and to evaluate their clinical values. Methods For 155 patients suspected with bladder cancer NMP 22 and cytology were conducted in the same voided urine samples.Of them 95 patients with bladder transitional cell carcinoma were confirmed histologically.The sensitivity and specificity of NMP 22 and urine cytology were analyzed.60 patients without bladder cancer were selected as control. Results The overall sensitivity and specificity of NMP 22 test were 65.3% and 70.0%,respectively,those of urine cytology were 43.2% and 83.3%,respectively.There was no significant difference between the specificity of urine cytology and that of NMP 22 test;however,NMP 22 was significantly more sensitive than urine cytology in detection of any stages and grades of bladder cancer(P

Objective To outline the diagnosis and treatment of a through-and-through urinary bladder to rectum-anal canal injury. Methods To review and summary 13 cases of through-and-through urinary bladder to rectum-anal canal injury.All patients were male and average age of 37 years old.Among them 4 cases reached hospital in 6 hours after injury,5 cases during 6～12 hours and 4 cases over 12 hours.Debridment and suture of urinary bladder to rectum-anal canal injure,effective revolution of urine and stools and full drainage in anterior sacrum space were performed.All of the 13 cases experienced operation of bladder exploration and drainage.1 among them underwent prostate gland cuting off because of the prostate gland injury.Another received the operation of urethra anastomoses.Both of them keep on catheterizing after operation.The management of anus and rectum hurt:3 cases received clearing and sewing up the wounnd of anus sphincter.8 cases received the repair of rectum passing through the anus.4 cases were not given remedy.7 patients received placing double thimble in the gap before sacrum.4 patients recieved placing eduction tube in the original wound.12 patients were given the operation of making sigmoid flexure fistula. Results All the 13 cases were cured.2 cases had postoperative infection in anterior sacrum space and were cured by full drainage.1 case was cured by secondary repairment after anal spincter repaired unsucessfully.1 case with rectovesical fistula was cured by conservative treatment.None suffered from dysuria,importence or anal stenosis.12 cases were visited and 1 was lost.Follow up was conducted from 10 months to 6 years.1 case with mild bowels incontinence recovered after training of lifting the anus for half a year.1 patient suffered from bladder calculi after a year and healed through lithotrity under cystoscope.The remaining 10 urinate and defecate normally,amonmg them 1 experienced urethra extends 6 times. Conclusions It was the key of improving treatment effect to master the clinical feature of a through-and -through urinary bladder to rectum-anal canal injury and diagnose correctly in the early stage and select reasonable operative procedure.

Objective To observe the baseline characteristics and visual outcomes after two years follow-up of exudative age-related macular degeneration (AMD) patients treated with ranibizumb. Methods Forty-four eyes of 44 patients with exudative AMD were enrolled into this retrospective study, 19 were men and 25 were women. The mean age was 78 years (range 64–92 years). All patients were underwent best corrected visual acuity (BCVA, Early Treatment of Diabetic Retinopathy Study), fundus color photography, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT). The mean BCVA was (50.36±14.43) letters, the mean central foveal thickness (CFT) was (291.95± 82.19)μm, and the fluorescence leakage area of choroidal neovascularization (CNV) was (7.61±5.84) mm2. All patients received three initial intravitreous injection of ranibizumb (IVR) and were retreated with monthly IVR when needed. The mean follow up time was 25.6 months (range 24–29 months). On 1, 2, 3, 6, 12, 18 and 24 months after treatment, BCVA and OCT were repeated. On 3, 6, 12, 18 and 24 months after treatment, FFA and ICGA were repeated. The change of BCVA, CFT and fluorescence leakage area of CNV were observed. The association of baseline characteristics and two year visual outcomes were analyzed. Results On 1, 2, 3, 6, 12, 18 and 24 months after treatment, the BCVA were improved significantly (t=?1.89,?3.51,?4.61,?4.04,?5.77,?4.69;P<0.05), the CFT were decreased significantly (t=1.51, 2.30, 3.40, 3.28, 3.54, 3.88, 3.73;P<0.05). On 3, 6, 12, 18 and 24 months after treatment, the fluorescence leakage area of CNV were reduced significantly (t=2.12, 2.90, 3.51, 4.12, 4.06;P<0.05). The lower baseline BCVA, the more improved after treatment. The BCVA improvement degree has a negative relationship with baseline BCVA and fluorescence leakage area of CNV (r=0.505,?0.550;P<0.05), but no correlation with baseline CFT (r=0.210, P>0.05). Conclusion Two year visual outcomes of exudative AMD patients treated with ranibizumb is negative correlated with baseline BCVA and fluorescence leakage area of CNV, but not correlated with baseline CFT.

ObjectiveTo investigate the etiology, exacerbating factors and outcome of geriatric patients with acute renal failure (ARF) in emergency and critical internal medicine. MethodsClinical features of elderly inpatients with ARF who were diagnosed in internal medicine of our hospital during the past 10 years were retrospectively analyzed. Patients were divided into community-acquired ARF (CA-AFR) group and hospital-acquired ARF (HA-ARF) group. Comparisons between CA-ARF group and HA-ARF group, and between elderly patients and non-elderly patients with ARF in internal medicine were performed. ResultsAmong 381 elderly ARF patients in internal medicine, there were 218 (57.2%) CA-ARF patients and 163 (42.8%) HA-ARF patients. Most of the HA-ARF patients (153 cases) were distributed in medical intensive care. Compared with CA-ARF group, patients in HA-ARF group were older, with more underlying diseases, a higher ratio of infections and/or heart failure and more severe acute renal failure. Infection and heart failure/severe myocardial isehemia were the major exacerbating factors for HA-ARF. Of the 163 patients with HA-ARF, 146 patients died and 17 patients survived. Patients in the death group had more underlying diseases, a higher ratio of severe infections and heart failure/severe myocardial ischemia, a higher ratio of cases with multiple organ dysfunction syndrome(MODS) and a higher score of APACHE Ⅱ.When compared with non-elderly patients with ARF, the elderly patients had a higher proportion ofHA-ARF, a higher ratio of MODS, a higher score of APACHEⅡ and a higher mortality of ARF.ConclusionsThe elderly critical patients are susceptible to HA-ARF with more chronic underlying diseases. Infection and heart failure/severe myocardial ischemia are the major exacerbating factors.The prognosis depends on the treatment of predisposing diseases and removal of exacerbating factors.