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.

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.

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.

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.

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)

ObjectiveTo analyze the neurological manifestations of chronic mercury poisoning for the improvement of clinical understanding of this disease.MethodsThe clinical data of 8 cases diagnosed as chronic mercury poisoning admitted in the department of neurology of Xuanwu hospital during the past 5 years were collected and analysed.Results Neurological manifestations of chronic mercury poisoning involved psychological problems,sleep disorders,ataxia,extremities weakness and atrophy,tremor,peripheral neuropathy and paresthesia.ConclusionsThere are various kinds of neurological manifestations of chronic mercury poisoning.Identification of these manifestations in clinical practice and early diagnosis are beneficial for the relief of pains in the patients.

Objective To evaluate the efficacy of intravitreal injections of conbercept in choroidal neovascularization (CNV) secondary to pathologic myopia (PM).Methods A retrospective case series of 37 eyes of 37 patients affected with CNV secondary to PM treated by intravitreal injections of Conbercept.All the patients were examined with best-corrected visual acuity (BCVA) of Early Treatment Diabetic Retinopathy Study (ETDRS) chart,central macular thickness (CMT) of optical coherence tomography (OCT) at baseline.The initial average letters of ETDRS BCVA was 49.86±8.87,CMT was (306.38±31.01) μm.All eyes were treated with intravitreal Conbercept 0.05 ml (10 mg/ml).Follow up visits were performed monthly after injection.The mean follow-up time was 16.8 months.Injections were repeated according to the situation of BCVA,CMT,subretinal fluid and CNV leakage in follow-up.All eyes received an average of 4.8 injections.BCVA,CMT and ophthalmoscope examination were assessed monthly.The relationship of BCVA improvement and CMT reduction with the data at baseline and number of treatments were analyzed by Spearman Rho correlation respectively.Results During the 1,3,6 and 12 months after treatment,the mean BCVA were all improved with statistically significant difference (t=17.629,P＜0.01).At 12 months,15 eyes (45.9％) had improvement of 15 letters or more,32 eyes (86.5％) had improvement of 5 letters or more,and 1 eye (2.7％) had decreased more than 5 letters.During the 1,3,6 and 12 months after treatment,the mean CMT were all decreased with statistically significant difference (F=43.726,P＜0.01).At 12 months,the retinal fluid of 34 eyes (91.9％) were absorbed completely;33 eyes (89.2％) had angiographic closure at that time.There was no significant relevance between BCVA improvement and sex,age and course of the disease (P＞0.05),but a significant negative correlation was found between the BCVA improvement and BCVA at baseline,injection times (P＜0.05).There was no significant relevance between CMT reduction and sex,age,course of the disease and injection times (P＞0.05),but a significant positive correlation was found between CMT reduction and CMT at baseline (P＜0.05).There were no systemic or ocular serious side effects during the follow up.Conclusions Intravitreal injections of Conbercept showed BCVA improvement and CMT reduction.It appeared to be effective and safe for choroidal neovascularization secondary to pathologic myopia.Intravitreal Conbercept for CNV secondary to PM showed BCVA improvement,CMT reduction and safety.

Objective:To establish a method for the content determination of pantoprazole sodium for injection by high performance capillary electrophoresis. Methods:The determination was performed on an uncoated elastic quartz capillary column, the running buff-er was 0. 01 mol·L-1 potassium dihydrogen phosphate buffer, the running voltage was 25kV,the column temperature was 25℃ and the detection wavelength was 289 nm. Results:The linear range was good within the concentration range of 20. 05-200. 51 μg·ml-1(r=0. 999 6). The average recovery was 99. 03%(RSD=0. 86%, n=9). Conclusion:The method is simple, sensitive and reproduci-ble, and can be used in the determination of pantoprazole sodium for injection.

Objective To evaluate the effectiveness and safety of dexmedetomidine for the sedation of the patients after coronary artery bypass grafting (CABG).Methods The selective 96 CABG patients,ASA Ⅱor Ⅲ,aged 36 to 68 years old,58 males and 38 females,were randomly divided into 2 groups (n =48):dexmedetomidine group (group A) and midazolam group (group B).Group A patients received Dexmedetomidine (1.0 μg/kg)over 10 min,followed by 0.2-0.7 μg · kg-1 · h-1 to maintain sedation,whereas the other group patients received midazolam (0.05 mg/kg) over 10 min,followed by 0.02-0.10 mg · kg-1 · h-1 to maintain sedation.Two groups of patients stopped using drug when they were fit off-line and extubation.Observe the percentage of time within target sedative scope (Riker range 3-4),the changes of vital signs before and after treatment,the prevalence of delirium,the awakening time,the duration of mechanical ventilation,ICU length of stay,the adverse events of blood pressure and heart rate.Results There were no significant difference in the percentage of time within target sedative scope between two groups (75.5％ for dexmedetomidine group vs 74.6％ for midazolam group,P ＞ 0.05).Compared to midazolam group,the Dexmedetomidine group has a shorter awakening time [(14.0 ± 6.2) min for dexmedetomidine group vs (50.4 ± 12.8) min for midazolam group,P ＜ 0.05] and duration of mechanical ventilation,and also the prevalence of delirium was lower(15.3％ for dexmedetomidine group vs 34.6％ for midazolam group,P ＜0.05).ICU length of stay was similar.Dexmedetomidine-treated patients were more likely to develop bradcardia,with a non significant increase in the proportion requiring treatment,but had a lower likelihood of tachycardia or hypertension requiring treatment.Conclusion Dexmedetomidine is safe and effective in patients after CABG surgery.

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.