Based on insoluble phenomenon in trace metal powder in TCM granules produced by small and medium-sized pharmaceutical companies, this article discussed the causes and countermeasure from the aspects of formulation composition, preparation technology, and TCM pretreatment, with a purpose to provide the basis for strengthening the quality standard of TCM granules.

Objective To study the safety and clinical efficacy of transurethral 120 W 2 μm laser prostate vaporesection in the treatment of benign prostatic hyperplasia (BPH).Methods Forty-one BPH cases were treated with 2 μm continuous wave laser prostate vaporesection.Laser output power was 120 w.International prostate symptom scores (IPSS) were collected on all patients before and after surgery at one,six and 12 months for maximum urinary flow rate (Qmax) and post-voiding residual urine volume (PVR).Operative time,estimated bleeding loss,electrolyte changes,and the time of catheter removal were recorded and analyzed respectively.Results All procedures were successfully completed.The obstructive symptoms of lower urinary tract symptoms were relieved in varying degrees post-operatively.Preoperative and postoperative one,six and 12 months IPSS,Qmax and PVR showed statistical difference ( P ＜0.01 ).Operative time was 32.9 ± 10.7 min,decreased hemoglobin levels was 5.36 ± 2.78 g/L,no cases needed blood transfusion,and all patients were without electrolyte disturbance resulted in the safe perioperative period.The time of removal of the catheter was 2.5 ± 0.7 d.There was no secondary surgery,urinary incontinence,and complication such as bladder neck contracture at 12 months post-operative follow-up.Conclusions RevoLix 2 μm continuous wave laser prostate vaporesection as a treatment option for BPH is safe and effective over a short and long period of time.RevoLix 2 μm wave laser prostate vaporesection can significantly improve BPH patient symptoms of lower urinary tract obstruction.

OBJECTIVE:To provide reference for implementing pharmaceutical care for secondary prevention of patients with myocardial infarction and improving medication compliance by clinical pharmacist. METHODS:A questionnaire survey was con-ducted for 200 secondary prevention patients with myocardial infarction in our hospital,and divided into good medication compli-ance group and poor medication compliance group by Morisky-Green(MG)standard scoring evaluation, and the reasons affecting the medication compliance were statistically analyzed. RESULTS:Totally 200 questionnaires were sent out,200 were effectively re-ceived with effective recovery of 100%. 137 patients showed good medication compliance and 62 patients showed poor medication compliance,there were statistically significant differences in the age,monthly income,whether there was a medical insurance or not,whether they live alone or not and whether they had more than 4 oral drugs between 2 groups(P<0.05). The reasons of poor medication compliance were forgetting to take the medicine,too many kinds of medicine,too expensive to afford the medicine, lacking the knowledge of the disease and poor medication guide. CONCLUSIONS:The poor medication compliance of patients with secondary prevention of myocardial infarction is closely related with elder age,low income,no medical insurance,living alone,and taking more than 4 kinds of medicine. Clinical pharmacists should play their professional expertise,repeatedly supervise patients'medication compliance and finally improve the efficacy and patients'quality of life.

Objective To evaluate the safety and efficacy of retroperitoneal laparoscopic resec-tion and reconstructive surgeries in urology. Methods Retroperitoneal laparoseopic resection and re-constructive surgeries were performed on 245 patients including 17 cases of adrenalectomies, 32 cases of radical nephrectomies, 12 cases of partial nephrectomies, 53 cases of nephrectomies, 5 cases of nephroureterectomies, 6 cases of unroofing of peripelvie renal cysts, 46 cases of unroofing of renal cysts, 4 cases of unroofing of polyeystic kidneys, 12 cases of pyeloplasties, 58 cases of ureterolithoto-roles. Results All 245 surgeries were successfully completed. The mean operation time was 59 (20-250) min and the estimated blood loss was 5-300 ml with no transfusion. There was no serious complication during perioperative period. Conclusion Retroperitoneal laparoscopic resection and re-conatruetive surgery in urology is safe and effective with the advantages of minimal invasion, quick re-covery and few complications.

OBJECTIVE:To provide reference for improving practical teaching system of biomedical specialty talents training. METHODS:Based on the present situation of practical teaching system in higher vocational education,combined with the develop-ment of biomedicine industry,referring to foreign experience about vocational education mode,using the elements of the practice teaching system as the breakthrough points,hardware and software of practical teaching were highlighted and strengthened;the practical teaching system was established fromability oriented,practical teaching as the leadingpractical ability of vocational stu-dents and vocational ability talent training mode. RESULTS:The practical teaching system of biomedical specialty talents training was established on the basis ofthree-capacity,one body two wingspractical teaching target system,three standards,hierarchi-cal and modularpractical teaching content system,system and institutions,hardware and software managementstandard man-agement system,progressive training base platform,dual-level teaching staff,practical teaching supporting system of talented teacher group. CONCLUSIONS:The practical teaching system strengthen comprehensive practice ability training, can realize win-win between college and government,and of society. It can provide reference for improving practical teaching system of bio-medical specialty talents training.

Objective To observe toxic symptoms and signs , toxic damage extents and reversibility in rats after oral administration of Tangwang Mingmu granules .Methods Four dose groups with 40 rats in each group were designed in this study, including control group fed with distilled water and three groups at different dosages of the test drug .Tangwang Mingmu granules were orally administered to SD rats at the dosage of 8.4, 4.2 and 2.1 g/kg for 3 weeks and 14.0, 8.4 and 4.2 g/kg for 23 weeks, for 26 consecutive weeks .The general state of the rats was observed every day , while body mass and food consumption were calculated once a week .Halfway through and at the end of the administration (13 and 26 weeks) and after four weeks of recovery, parameters of body mass, hematology, hematological biochemistry, organ/body mass ratio and histopathology were measured .Results Compared with the control group at the same time-point, body mass of male rats in the other three groups was slightly reduced .Food consumption in high and medium dose groups was reduced (P<0.05), MCHC, ALT, TBIL and Na +in high dose group were decreased (P<0.05), TP, ALB and D-BIL were increased (P<0.05), the mean body mass and relative organ weight of thymus in medium dose male rats were decreased (P<0.05), relative organ weight of the liver and kidney in high dose male rats was increased (P<0.05), and focal chronic inflammation to different extent was observed in the liver , kidney and prostate gland .No dose-effect relationship was found in these perturbations that were all within the normal range of animals .No significant drug-related pathological changes were found.Conclusion The NOAEL of Tangwang Mingmu granules is considered to be 14.0 g/kg body mass/day (equal to 50 times the proposed clinical adult dosage ) for the 26-week repeated dose oral toxicity study in male andfemale rats.

Objective To analyze the etiology and prognosis of severe complications of percutaneous nephrolithotomy (PCNL).Methods The clinical data of patients with severe complications after PCNL from December 2004 to December 2015 were retrospectively analyzed.Age of the patients ranged from 25 to 69 years old,with an average of 41 years.There were 64 cases with 29 male and 35 female.Fifty-five cases were diagnosed as renal calculi,including 21 cases of left renal calculi,19 cases of right renal calculi;15 cases of bilateral renal calculi;2 cases of the patients were bilateral upper ureteral calculi;7 patients were renal calculi upper ureteral calculi on the other side.In all cases,the maximum diameter of calculus was 1.8-4.3 cm (mean 2.6 cm) and hydronephrosis depth was 0-5.9 cm (mean 2.3 cm);15 cases were previously treated with nephrolithotomy.The modified Clavien grading system was used to evaluate surgical complications,and ≥grade Ⅲ complications were considered as serious complications.Results Among the 64 cases,28 cases were classified as Clavien Ⅲ class.There were 2 cases of bleeding in operation due to renal parenchyma laceration or multiple access,patients were treated with later open surgery.Postoperative bleeding were revealed in 22 cases,16 of which were hemorrhage from the nephrostomy tubes,4 of which complained of discontinuity gross hematuria and 2 postoperative bleeding were encountered during the nephrostomy tube remove.All the cases received renal arteriography and were diagnosed with pseudoaneurysm,bleeding were stopped after embolization.3 cases of pleural injury were treated with closed thoracic drainage,1 colon injury was treated with open colostomy.There were 32 cases of urinary sepsis considered as Clavien Ⅳ complications,and these patients were transferred to the Intensive Care Unit.Clavien Ⅴ class 4 cases:1 died of hemorrhagic shock due to pleural injury,2 cases died of urinary sepsis and multiple organ failure and another case died of pulmonary embolism.Conclusions PCNL has high risk of serious complications,which should be always strictly follow the principles.Adequate preoperative preparation,appropriate surgery access,carefully and gently operate,appropriate antibiotic use and postoperative management are the key measures to reduce the incidence of complications.

Objective To establish a prostate urethral re-epithelialization model with Chinese rural canine by 2 μm laser vaporization resection.Methods We used 2 μm laser to vaporiz prostate of 15 uncastrated male Chinese rural canines from March to April in 2016.These canines mean age was (6.3 ± 0.6) years(ranging 5-7 years),and weight was (20.5 ± 1.3) kg(ranging 18-22 kg).We began to surgery in which we saw the protruding part of the prostate in urethra,and narrow prostate urethra after a successful anesthesia by intraperitoneal injection of chloral hydrate.The operation time,anesthesia time,survival rate,first time to drink water,first time to feed,first time to stand,first time to defecate,the time when canine bladders rinse became clear,wound healing time were recorded.After 3 days,1 week,2 weeks,3 weeks and 4 weeks,we randomly select 3 canines to observe regeneration of prostate urethra wound under cystoscope.After surgery,the bladder,prostate and prostate distale urethra were removed to make specimen and measure the diameter size of prostate.The HE staining and immunohistochemistry was performed in each sample.Results The experimental operation time was (70.5 ± 18.3) min (ramging 50-90 min).The average anesthesia time was (120.1 ± 21.1) min (ranging 95-145 min).The survival rate was 100％.In post surgery duration first standing time,first eating time,first drinking water time,first defecation time were (6.5 ± 1.8) h,(10.3 ± 2.1) h,(23.7 ± 5.6) h,(26.3 ± 3.1) h,respectively.The time when canine bladders rinse became clear and wound healing time were (5.2 ± 1.6) d,(8.7 ± 1.5) d respectively.Cystoscopy observated that the wound was covered by pale necrotic tissue 3 d and 1 week after operation,covered by epithelium 2 weeks after operation,covered by more thicker epithelium 3 weeks after operation,covered by epithelium which color was close to normal urothelium 4 weeks after operation.HE staining observated that the wound wasn't covered by epithelium 3 d after operation,partial wound was covered by flaky single or 2-3 cubic regenerated epithelial 1 week after operation,all wound was covered by epithelial which was lack of polar 2 weeks after operation,wound was covered by polarity epithelium which was thicken to 5-6 layer and observated a little umbrella cells on the surface 3 weeks after operation,wound was covered by polarity epithelium which was thicken to 5-6 layer and observated much umbrella cells on the surface 4 weeks after operation.Immunohistochemical staining observated that urinary spot protein from the wound or epithelium was negative 3 d,1 and 2 weeks after operation,urinary spot protein from the part of epithelium was positive 3 weeks after operation,and urinary spot protein from all epithelium was positive 4 weeks after operation.Conclusion It is feasible to establish prostate urethral re-epithelialization model in the Chinese rural canine by 2 μm laser vaporization resection of the prostate.

Objective To investigate the timing of super-selective renal artery embolization (SRAE) for the treatment of renal hemorrhage after percutaneous nephrolithotomy (PCNL) .Methods From June 2005 to February 2013 ,a total of 2 165 patients with upper urinary tract calculi underwent PCNL (2 384 PCNL procedures) and 16 of them suffered severe bleeding (0 .74% ) .In the 16 cases ,SRAE was used .The medical records of all the 16 cases were retrospectively analyzed .Results In 16 patients ,15 patients were successful with the first SRAE ,but 2 of them underwent an additional pure renal artery angiography (1 patient before SRAE and 1 patient after SRAE);1 healed after the second SRAE .The mean blood loss and transfusion volume were 32 .9 g/L and 250 mL before the first angiography/SRAE ,and an additional 3 .2 g/L and 0 mL before the second try .Although 1 patient died ,the oth-ers were recovered without complications .Conclusion SRAE should be adopted early for the treatment of severe renal hemorrhage after PCNL .However ,a second try should be considered for the repeated bleeding patients after the negative results of first renal artery angiography or SRAE .