Objective To evaluate the efficacy and safety of Fosfomycin trometamol(FMT)versus Norfloxacin(FPA)in elderly diabetic patients with acute urological tract infections.Methods From Jan.2012 to Mar.2013,eighty-six patients with uncomplicated and complicated urinary tract infection were randomized into FMT group(n =43)and FPA group(n =43).Patients in both groups were balanced with regard to baseline urinary tract symptoms,fever,leukocytosis,positive urinary culture and disease type(P＞0.05).Patients received FMT 3 g daily and Norfloxacin 0.4 g twice daily for a week.Extended treatment was given to 35 patients not cured within a week.Total treatment course should not exceed two weeks.Patient's symptoms,signs,complete blood count,urinalysis,urine culture,pharmacological sensitivity tests,renal and liver function tests were performed.Results After one week of FMT treatment,28(65.1％)cases were cured and 10 cases were improved(1 was with abnormal urinalysis,9 had positive urine culture).In total,in 38(88.4％)patients treatment was as effective;In FPA group,23(53.5％)were cured and 7 cases were improved(7 had positive urine culture).In total,there were 30(69.8％)patients classified as effective.Difference was statistically significant(P＜0.05 =.After 2 weeks of FMT treatment,38(88.4％)cases were cured and 2 patients were improved(1 was with abnormal urinalysis,1 had positive urine culture).In total,40(93.0％)patients were classified as effective.In FPA group,25(58.1％)cases were cured and in 8 patients were improved(8 had positive urine culture).In total,there were 33(76.7％)patients classified as effective;Difference was statistically significant(P＜0.05 =.Bacterial clearance rate in FMT and FPA group was 88.9％ and 72.7％,respectively.Difference was statistically significant(P＜0.05 =.The adverse reaction rates were 9.3％ and 14.0％,respectively.Difference was not statistically significant(P＞0.05).Conclusions FMT is an effective and safe antibiotic in the treatment of urinary tract infections in elderly diabetic patients.

Objective:To investigate the fear of disease progression in middle-aged and elderly patients with bladder cancer after bladder irrigation for the first time, and analyze its influencing factors.Methods:From August 2018 to December 2019, 145 non-muscular invasive bladder cancer patients with bladder infusion chemotherapy who underwent transurethral resection of bladder cancer in the Department of Urology, Shanghai Tenth People's Hospital, were selected as the research object. The General Information Questionnaire, Fear of Progression Questionnaire-Short Form (FoP-Q-SF) and the Brief Illness Perception Questionnaire (BIPQ) were used to conduct a questionnaire survey to analyze the fear of middle-aged and elderly patients with bladder cancer and its influencing factors.Results:Among 145 middle-aged and elderly patients with bladder irrigation, the total score of fear of disease progression was (28.32±7.34) , the scores of physiological health dimension and social family dimension were (18.24±4.32) and (10.11±5.46) respectively, and the total score of ill perception was (44.12±10.65) . The total score of the fear of disease progression of patients was positively correlated with the total score of ill perception ( r=0.61, P<0.01) . Univariate analysis showed that there were statistical differences in the scores of fear of disease progression among middle-aged and elderly bladder irrigation patients with different ages, personal monthly incomes, religious beliefs, tumor lesions, tumor tissue grade, tumor disease progression or recurrence ( P<0.05) . Regression analysis showed that the independent influencing factors of the fear of disease progression in middle-aged and elderly patients with bladder irrigation included the religious belief, tumor tissue grade, tumor disease progression or recurrence with a statistical difference ( P<0.01) . Conclusions:Clinical medical and nursing staff should pay attention to the fear of disease progression in middle-aged and elderly patients with bladder perfusion, especially those with high grade tumor tissues, who are in the advanced stage of tumor, and have no good psychological suggestion. At the same time, we can reduce their fear of disease progression by improving disease perception.