Objective To discuss the therapeutic effect of treating diabetic neurogenic bladder with integrative medicine. Methods 60 patients with diabetic neurogenic bladder were randomly recruited into a treatment group and a control group. The treatment group (30 cases) treated with methylcobalamin, pancreatic kallikrein enteric-coated tablets and Guantong decoction, while the control group (30 cases) was treated with western medicine exclusively. The residual urine volume and symptoms were observed before and after the treatment. Results The treatment group showed significantly better results in improving the symptoms and reducing the residual urine volume than the control group(P＜0.05).Conclusion It is curative to treat diabetic neurogenic bladder with integrative medicine.

Objective To investigate the infection status of Ureaplasma urealyticum (Uu) and its situation of drug resistance . Methods The separation ,identification and drug resistance test plate was used for Uu detection in 3 249 cases of cervical samples . Results The total infection rate of Uu was 47 .18% (1 533/3 249) .The patients with Uu infection mainly distributed in >20-40 years ,with the constituent ratio accounted to 90 .8% .The sensitive rates of Uu to josamycin and doxycycline were both higher than 95 .00% ,however ,the resistant rate of Uu to azithromycin and ofloxacin were both higher than 50 .00% .Conclusion The drug re‐sistant strains of Uu were common .The clinic should choose the sensitive antibiotics for the treatment according to the results of drug sensitivity test .

Objective To explore the relation of the expressions of MDM2 and VEGF in osteosarcoma with the pathological parameters and prognosis of the tumor.Methods The expressions of MDM2 and VEGF were detected with immunohistochemical(SP) method in specimens from 56 cases of osteosarcoma.The correlation between the expressions of MDM2,VEGF and pathological grade,metastasis and prognosis was analyzed statistically.while 8 cases of fibrous dysplasia of bone were used as negative control group.Results The positive rates of MDM2 and VEGF in osteosarcoma were 64.3%(36/56) and 67.9%(38/56),respectively .MDM2 and VEGF didn't express in negative control group.The expression of MDM2 and VEGF were not significantly correlated to the pathological grades of the osteosarcoma,but which were significantly correlated with tumor metastasis and prognosis(P

Objective To evaluate the accuracy and reliability of 4D time-resolved MRA with keyhole (4D-TRAK) for the detection and characterization of cerebral aneurysms ( CAs),with a comparison of 3D time-of-flight MRA (3D-TOF-MRA).Methods3D-TOF-MRA,4D-TRAK and 3D-DSA were performed sequentially in 52 patients with suspected CAs.4D-TRAK was acquired using a combination of sensitivity encoding (SENSE) and contrast-enhanced (CE) timing robust angiography ( CENTRA ) k-space sampling techniques at a contrast dose of 10 ml at 3 T scanner. Accuracy,sensitivity,specificity of 4D-TRAK and 3D-TOF-MRA were calculated and compared for the detection of CAs on patient-based and aneurysm-based evaluation using 3D-DSA as a reference. Wilcoxon signed rank test were used. Results The overall image quality of 4D-TRAK was appropriate for the diagnostic purpose,but yet not comparable with that of 3D-TOF-MRA.In 52 patients with suspected GAs,58 CAs were confirmed on 3D-DSA finally.Fifty-one (with 2 false-positives and 9 false-negatives) and 58 (with 1 false-positive and 1 false-negative)CAs were visualized on 4D-TRAK and 3D-TOF-MRA,respectively.Accuracy,sensitivity and specificity on patient-based evaluation of 4D-TRAK and 3D-TOF-MRA were 92.31％ ( 48/52 ),93.33％ ( 42/45 ),85.71 ％ (6/7) and 98.08％ ( 51/52 ),100.00％ ( 45/45 ),85.71％ ( 6/7 ),respectively,and 74.07％(20/27),75.00％ ( 18/24),66.67％ (2/3) and 96.30％ (26/27),95.83％ (26/27),100.00％ (3/3)on aneurysm-based evaluation in patients with multiple CAs,respectively.Subgroup analysis revealed that for 19 very small CAs ( maximal diameter ＜3 mm,measured on 3D-DSA),9 were missed on 4D-TRAK and 1 on 3D-TOF-MRA( Z =- 2.464,P ＜ O.01 ). However,for 39 CAs with maximal diameter more than 3 mm,there was no significantly difference in the diagnostic accuracy (39 on 4D-TRAK vs.39 on 3D-TOFMRA) (Z =0.000,P ＞0.05).In 4 large CAs with maximal diameter more than 10 mm,4D-TRAK provided a better characterization of morphology than 3D-TOF-MRA.Conclusions 4D-TRAK with a combination of SENSE and CENTRA at 3 T shows potential value in the diagnosis of cerebral aneurysms.However,due to the compromise in spatial resolution and vascular edge artifacts,it does not yet have a diagnostic accuracy of CAs comparable with 3D-TOF-MRA.TRAK imaging can be of great help in patients with large-giant CAs to characterize the morphology of CAs and to diminish the risk of NSF in patients with renal impairment by using a lower-dose contrast.

Objective To determine the lower limit of detection (LLOD) and cut off values of K-ras mutation detection by peptide nucleic acid (PNA) clamping-PCR.Methods The genomic DNA of pancreatic cancer cell lines (PANC1 and SW1990) with codonl2,13 mutation and the genomic DNA of placenta with K-ras wild type were mixed and diluted serially into samples with different mutation rate (0,0.1％,0.2％,0.4％,0.8％,1.6％,3.1％,6.25％,12.5％,25％,50％),PANC1 cells with 1％ mutation rate and SW1990 cells with 30％ mutation rate and 4 samples with the quantity of DNA was 50,20,5,1 ng and 50,10,5,1 ng was prepared.Codon 12,13 mutation of K-ras was determined by PNA-PCR,and the mutation Ct values,overall Ct values were collected,and the △Ct values (mutation Ct values-overall Ct values) were calculated,and the tests were repeated for 10 times.ROC curve was used to analyze the △Ct values and determine the best cut off values for K-ras mutation,and the positive diagnostic rate,LLOD was evaluated.Results The mutation Ct,△Ct values of codon 12 mutation of PANC1 and codon 13 mutation of SW1990 of all the different mutation rates were statistically significantly different (P ＜ 0.05) when compared with negative control group,but the overall Ct values were not statistically significantly different from that of negative control group.For detection of K-ras codon 12 mutation by ROC curve,the relevant area of ROC curve (AUC) was 0.926,the optimum cut off value of △CT was 11,the sensitivity and specificity were 84％ and 100％,respectively,and the LLOD was 0.4 ng.For detection of K-ras codon 13 mutation by ROC curve,the relevant AUC was 0.906,the optimum cut off value of △CT was 9.5,the sensitivity and specificity were 71％ and 100％,respectively,and the LLOD was 1.5 ng.The mutation detection results of fixed rate further confirmed the LLOD.Conclusions This study successfully defines LLOD and cut off value of PNA clamping-PCR/K-ras method in detection of K-ras 12 and 13 codon mutations.This method meets the requirement of clinical application.

Purpose: Body image changes are common among patients living with inflammatory bowel disease (IBD) because of the illness and related treatments. Currently, there is little known about how those patients experience and perceive their altered body image in the literature. The aim of this study was to explore the experiences of body image changes in patients with IBD in China and to describe how those changes influence patients’ perception of body and self. Methods: This study used a descriptive qualitative approach. A total of 16 participants from three tertiary hospitals in southeast China were recruited through purposive sampling combined with maximum variation strategy. Data were collected through semistructured interviews and analyzed using conventional content analysis method. Results: The following six themes were extracted: (1) “being a constrained person,” (2) “being a flawed person,” (3) “being a disliked person,” (4) “being an alienated person,” (5) “being a reconciled person,” and (6) “being a blessed person.” Conclusion With the diagnosis of IBD and its side effects of treatments, patients’ life changed significantly and they were struggling to reinterpret their body and self. As a result, negative self-evaluations and/ or positive self-evaluations towards themselves generated. Further studies are required to explore the underlying mechanism and related influencing factors about how those different images were produced.

Purpose: Body image changes are common among patients living with inflammatory bowel disease (IBD) because of the illness and related treatments. Currently, there is little known about how those patients experience and perceive their altered body image in the literature. The aim of this study was to explore the experiences of body image changes in patients with IBD in China and to describe how those changes influence patients’ perception of body and self. Methods: This study used a descriptive qualitative approach. A total of 16 participants from three tertiary hospitals in southeast China were recruited through purposive sampling combined with maximum variation strategy. Data were collected through semistructured interviews and analyzed using conventional content analysis method. Results: The following six themes were extracted: (1) “being a constrained person,” (2) “being a flawed person,” (3) “being a disliked person,” (4) “being an alienated person,” (5) “being a reconciled person,” and (6) “being a blessed person.” Conclusion With the diagnosis of IBD and its side effects of treatments, patients’ life changed significantly and they were struggling to reinterpret their body and self. As a result, negative self-evaluations and/ or positive self-evaluations towards themselves generated. Further studies are required to explore the underlying mechanism and related influencing factors about how those different images were produced.

Objective The aim of this study is to analyze the long-time outcome of hepatocellular carcinoma(HCC)patients with micro-vascular invasion underwent liver resection combined with transarterial chemoembolization(TACE).Methods Our database of surgical re-section from January 2009 to September 2015 was retrospectively analyzed.This study was conducted on 296 HCC patients with MVI.Patients were divided into two groups:one group underwent liver resection (n =159)and another for liver resection combined with TACE (n =137). The 5-year overall survival rate (OS)and disease free survival (DFR)were compared.A multivariate Cox proportional hazards regression a-nalysis was performed to assess the prognostic risk factors associated with overall survival rate.Results The 5-year OS and 5-year DFR see significant difference (OS:18% vs.8%,P =0.001;TRF:15% vs.8%,P =0.008).Multivariate analysis revealed that HBsAg(HR 1.596, P =0.002,95% CI 1.194 ~2.131),tumor size >5 cm(HR 0.729,P =0.042,95% CI 0.539 ~0.989)as well as multiple tumors(HR 1.480,P =0.049,95% CI 1.002 ~2.186)were correlated to poor overall survival rate.Conclusion Surgical resection combined TACE for HCC patients with MVI realized a better prognosis than patients merely underwent therapy of resection.

Objective To explore the application of bundle management in enhanced recovery after surgery (ERAS) on liver transplantation.Methods The multidisciplinary team of West China Hospital of Sichuan University discussed the program of ERAS on liver transplantation in 2016,and implemented this program in July 2016.A retrospective analysis was made on 220 liver transplant patients who were admitted to West China Hospital of Sichuan University in the period from Jan.2015 to Mar.2017.According to the inclusion and exclusion criteria,there were 104 patients in traditional group and 92 patients in ERAS group.The clinical indicators during and after surgery were compared between the two groups,and the applied value of ERAS on liver transplantation was analyzed.Results As compared with the traditional group,the patients in ERAS group had advantages in operative time,blood loss,postoperative stay in intensive care unit (ICU),transfusion volume in ICU,endotracheal intubation time and total hospitalization time,with significant difference between the two groups (P＜0.05).Meanwhile readmission and mortality rate after one month in ERAS group was not increased.Conclusion The bundle management in ERAS on liver transplantation of West China Hospital of Sichuan University can improve the prognosis of liver transplant patients.

Objective To explore the indications for liver transplantation among patients with hepatolithiasis.Methods Data from 1 431 consecutive patients with hepatolithiasis who underwent surgical treatment from January 2000 to December 2006 were retrospectively collected for analysis.Surgical procedures included T-tube insertion combined with intraoperative cholangioscopic removal of intrahepatic stones,hepatectomy,cholangiojejunostomy,and liver transplantation.Results Nine hundred and sixty-one patients who had a stone located in the left or right intrahepatic duct underwent hepatectomy or T-tube insertion combined with intraoperative cholangioscopic removal of intrahepatic stones.The rate of residual stones was 7.5%(72/961).Four hundred and seventy patients who had a stone located in the bilateral intrahepatic ducts underwent surgical procedures other than liver transplantation;the rate of residual stones was 21.7%(102/470).Only 15 patients with hepatolithiasis underwent liver transplantation;they all survived.According to the degree of biliary cirrhosis,recipients were divided into 2 groups: a group with biliary decompensated cirrhosis(n=7),or group with biliary compensated cirrhosis or noncirrhosis group(n=8).There were significant differences in operative times,transfusion volumes and blood losses between 2 groups(P