Objective To evaluate the short ferm effect of transurethral urethrotomy with the contact Nd:YNG laser for urethral stricture and obliteration. Methods 26 patients with urethral stricture or obliteration were treated with transurethral urehrotomy from August 1993 to October 1999.All patients underwent transurethral urethrotomy with the contact Nd:YNG laser delivered with the 600?m bare fiber at 30 to 50W.The urethrotomy was guided only by a metal sound introduced through the suprapubic tract. Results Satisfactory voiding was achieved after catheter removal in all patients.26 patients were followed up for 6～24 months.Normal micturation was observed in 24 patients(92.3%).Recurrent stricture occurred in 2 patients (7.7%).Of the 2 patients one needed periodical urethral dilatation and the other required repeat internal urethrotomy.The only complication was epididymitis in 2 patients.Urethroscopy was performed in 18 patients 4～12 weeks after catheter removal.Urethrotomy revealed a widely patent uretha with complete epithelialization at the site of the previous urethrotomy. Conclusions Transurethral urethrotomy with the contact Nd:YNG laser is a safe and effective treatment for urethral stricture and obliteration.The rate of stricture recurrence is relatively low.Complications not frequeutly seen and satisfectory short-term effect can be obtained.

Objective To explore the clinical characteristics of elderly patients with tuberculous meningitis (TBM) and analyze the causes of misdiagnosis.Methods The clinical data of patients aged 60 years and over with TBM in Beijing Chest Hospital Affiliated to Capital Medical University from January 2011 to January 2017 were retrospectively analyzed.The clinical characteristics of the elderly patients with TBM were analyzed and compared between misdiagnosis and non-misdiagnosis groups.Results Among 60 elderly patients with TBM,32 cases (53.3%) were misdiagnosed before hospitalization.Among 32 misdiagnosed cases,11 (34.4%) were misdiagnosed as pulmonary infection,6 (18.8%) as infectious diseases with unspecified site,4(12.5%) as upper respiratory tract infections and 3 (9.4%) as cerebral vascular diseases,and so on.The onset time of TBM,fever prevalence and CSF glucose levels were 42.5 (20.3,60.0) d,96.9% (31 cases),1.5(1.1,2.3)mmol/L in misdiagnosis group respectively,and 15.0 (10.0,20.0) d,75.0%(21 cases),2.3(1.4,3.2)mmol/L in non-misdiagnosis group respectively,which was statistically significantly different between the two groups (all P< 0.05).There were no statistically significant differences in age,gender,occupation,residence,complications,comorbidities,radiographic signs between the two groups (all P> 0.05).Conclusions Elderly patients with TBM have atypical clinical manifestations,many comorbidities,and less specific imaging,and especially,the cerebrospinal fluid pathogen sensitivity is low,which may result in higher misdiagnosis rate.