Objective To introduce an optimal incision technique in the endourethral surgery for urethratresia. Methods Sixteen patients suffering from urethratresia were managed by endourethral surgery,2 of them treated with rotator incision and the other 14 with rotator incision plus transurethral scar electrosectomy.The efficacy of the treatment was evaluated by Qmax. Results Successful incisions were achieved in all patients,the duration of procedure being from 18 to 33 min,with a mean of 25 min.Two patients with rotator incision had dysuria (Qmax 9 and 7 ml/s) after the surgery and accepted transurethral resection of scar again.The other 14 patients with rotator incision plus transurethral scar electrosectomy had good voiding.Qmax was more than 16 ml/s in all patients after operation. Conclusions Rotator incision is a safe,simple,efficacious incision technique in the endourethral surgery for urethratresia,and scar electrosectomy is essential for successsful outcome.

Objective To approach the effect of bed exercise for patients with intracranial aneurysm undergoing neural interventional treatment. Methods Ninety-six patients with intracranial aneurysm were divided into the test group(50 cases) and control group(46 cases).The control group received routine nursing, while the test group carried out bed exercise base on routine nursing. The incidence of complica-tions and changes of life quality were compared between the 2 groups. Results Lower incidence of com-plications took place in the test group than the control group(P ＜ 0.05).But changes in pulse rate and blood were not significant (P ＞ 0.05).The score of life quality in the physical domain and psychological domainwere not statistically different between the two groups (P ＜ 0.01 ),but no evident difference was seen in the domain of social relationship and environmental domain (P ＞ 0.05). Conclusions Bed exercise could al-leviated the anxiety and trepidation of patients with intracranial aneurysm,decrease the incidence of compli-cations such as body pain caused by absolute bed rest,thus improve patients' life quality.

Objective To investigate the therapeutic effect of epigallocatechin gallate (EGCG) on the bladder neo-plasm induced by N-methyl-N-nitrosourea (MNU) in Wistar rats. Methods Seventy-two female rats were randomly divid-ed into two groups, treatment group and control group. The rat model of bladder tumor was established by intravesical instilla-tion of MNU (2mL/time, once every two weeks) inside bladder. Rats in treatment group were given EGCG (2 mL/time, once/day), and control group were given the same volume of distilled water. Six rats were executed respectively at the 3rd, 5th, 7th, 9th, 11th and 13th week, and the bladder histopathological changes were studied in two groups. Results The untypical hyper-plasia was observed after 5 weeks. The bladder neoplasm was observed at the 11th week in control group. The bladder neo-plasm was not found in treatment group. There was a significantly lower pathological score in treatment group than that of control group except for the first two weeks (P＜0.05). Conclusion EGCG is effective for treatment of the bladder neo-plasm induced by MNU.

Objective To investigate the efficacy of peritoneal dialysis(PD) in the children with complex congenital heart disease after surgery.Methods 65 children with complex congenital heart disease were divided into group A(33 cases) and group B(32 cases).Group A was given PD when diuretics or urine output was less than 0.5ml per hour,while group B was given PD when urine output was less than 0.5ml per hour after 6h.The survival effect and indicators of PD before and after treatment were observed.Results The effective rate of group A (84.85％ ) was significantly better than group B ( 53.12％ ) ( x2 =5.18,P ＜ 0.05 ).The fatality rate of group A (9.09％ ) was significantly lower than group B ( 18.75％ ) ( x2 =5.32,P ＜ 0.05 ).The renal function was significantly improved.Urine output increased to the normal level,serum potassium,blood urea nitrogen,serum creatinine concentration were effectively controlled,the changes of indicators had significant differences before and after PD (t =5.22,3.46,46,4.89,4.77,all P ＜ 0.05).Conclusion PD was an effective support method for heart,renal insufficiency after the surgery of complex congenital heart disease,and it had good clinical effect for early application.

Objective To evaluate the effect of 5? reductase inhibitor on vascularity of benign prostatic hyperplasia (BPH). Methods Sixty male adult rats were randomly divided into 4 groups (15 per group): normal control, BPH control group, the group of 5? reductase inhibitor treatment during hyperplasia and the group of treatment after hyperplasia. Immunohistochemistry combined with computer assisted image analysis system were performed to examine the expression of factor Ⅷ related antigen, PCNA and VEGF in the prostatic tissue for all rats. Results The microvessel density(MVD) and the expressions of PCNA and VEGF were much less in treatment during hyperplasia and treatment after hyperplusia than that in BPH control group( P

Objective To investigate the influence of early rehabilitation on the recovery of patients who have undergone the low rectal cancer resection. Methods 130 patients with low rectal cancer resection were divided into the rehabilitation group and the control group randomly, there were 65 cases in each group. The control group were accepted the routine nursing care, and the rehabilitation group were accepted the early recovery intervention. Compared the time of anus exhaust, the time of stomach extubation, the incidence rate of postoperative complication, the time of bed rest and the quality of postoperative life in these two groups. Results All the indexes which have compared between these two groups were significant better in the rehabilitation group than those of in the control group, P

Objective To affirm the expression of Toll like receptor 4 (TLR4) on the surface membrane of platelet and to explore the immunomodulatory factors[(interlukine-8(IL-8),β-thromboglobulin(β-TG), soluble CD40 ligand(sCD40L)] released by platelets after platelets stimulated by TLR4 ligand.Methods TLR4 expressed on the platelet was detected by flow cytometry. Monoclonal anti-human FcγRⅡantibody(Ⅳ.3)-treated human platelets were cultured with LPS in the presence or absence of blocking monoclonal antibody to human TLR4. The release of IL-8, β-TG, sCD40L were measured by specific enzymelinked immunosorbent assay. Results Human platelets could express functional TLR4. The detection rate of TLR4 on platelets were decreased after LPS involvement(P<0.01). It was noted that sCD40L and β-TG were present in large concentration in the release of platelets stimulated by TLR4 ligand but the release of IL-8 was independent of platelet activation after TLR4 engagement. The concentration of sCD40L and β-TG had no statistical difference between 1-5 μg/ml LPS. The effects of LPS on the modulation of secretory factors were attenuated by preincubation of platelets with an anti-TLR4 monoclonal antibody. Conclusion The TLR4 on platelet could recognize and link LPS, induce the release of sCD40L, β-TG by platelet, but could not influence IL-8.

Objective To investigate the diagnosis and prognosis evaluation value of neutrophil elastase (NE) in ventilator-associated pneumonia (VAP).Methods A retrospective analysis was conducted.The data of patients undergoing mechanical ventilation admitted to Department of Central Intensive Care Unit (ICU) of Boai Hospital of Zhongshan City Affiliated to Southern Medical University from September 2012 to October 2015 were enrolled.The patients were divided into two groups according to whether they suffered from VAP or not.The content of NE in serum and bronchoalveolar lavage fluid (BALF) at the time of mechanical ventilation start,VAP diagnosis (the worst value from 48 hours after mechanical ventilation start to weaning in non-VAP patients),and at the time before mechanical ventilation weaning,as well as inflammation parameters,clinical pulmonary infection score (CPIS),duration of mechanical ventilation and prognosis were recorded.Receiver operating characteristic curve (ROC) was used to analyze the predictive value of NE on VAP diagnosis and prognosis.Results Finally 38 patients were enrolled in the VAP group,and 40 in non-VAP group,and baseline data was similar between the two groups.There was no significant difference in the content of NE in serum and BALF between VAP group and non-VAP group [serum NE (μg/L):67.04 (63.00,75.75) vs.69.00 (63.75,75.00),BALF NE (μg/L):96.26 (85.26,176.01) vs.95.26 (86.76,107.11),both P ＞ 0.05].From continuous monitoring,no significant change in the content of NE in serum and BALF during mechanical ventilation was found in the non-VAP group,but the content of NE in serum and BALF at the time of VAP diagnosis in VAP group was significantly higher than that at mechanical ventilation start [μg/L:157.00 (153.04,165.75) vs.67.04 (63.00,75.75),178.04 (153.00,188.25) vs.96.26 (85.26,176.01),both P ＜ 0.05],and NE content in serum and BALF was significantly decreased at the time after VAP clinical recovery and before mechanical ventilation weaning [μg/L:75.67 (64.51,110.55) vs.157.00 (153.04,165.79),95.50 (66.56,183.02) vs.178.04 (153.00,188.25),both P ＜ 0.05].The NE in the start time of VAP in VAP group was divided into four groups according to quartile,it was found that with the increase of NE content in serum and BALF,the CPIS was increased,the duration of mechanical ventilation was prolonged,and the prognosis was poor (all P ＜ 0.01).Compared with non-VAP group,white blood cell count (WBC),neutrocyte proportion,C-reactive protein (CRP),and procalcitonin (PCT) in VAP group were significantly increased (all P ＜ 0.01).NE in BALF was significantly positively correlated with WBC,neutrocyte proportion,CRP and PCT (r value was 0.507,0.432,0.779,and 0.519,respectively,all P =0.000),among which the highest correlation was CRP.NE in BALF used for VAP diagnosis has good accuracy,with sensitivity of 87.4％,and specificity of 90.6％,and sensitivity and specificity of NE in serum for VAP diagnosis was 78.6％ and 79.2％ respectively.Conclusion NE can be used as one of the indicators for VAP diagnosis,and it is related to the prognosis of VAP.

Objective To research the diagnostic value of troponin in the acute myocardial infarction after cardiac surgery.Methods The prospective study method was used.One hundred and thirtyfour patients of cardiac surgery were selected as observation group,36 patients of thoracic surgery were selected as control group.All the patients were given continuous electrocardiogram monitoring and measured troponin I,and the results were compared between the 2 groups.Results There was no statistical difference in the troponin I before anesthesia between the 2 groups (P ＞ 0.05).The troponin I 4 h after surgery was (13.010 ± 14.829) μg/L in observation group,(0.019 ± 0.007) μg/L in control group,there was statistical difference (P ＜ 0.05).One case of observation group happened the acute myocardial infarction after cardiac surgery,the troponin I was ＞ 40.000 μ g/L.Conclusions The troponin is obviously increased in the early stage in most patients of cardiac surgery,the false positive rate in diagnostic acute myocardial infarction is higher according to the troponin.For troponin,it will need the more evidence of evidence-based medicine to establish the diagnosis of acute myocardial infarction after cardiac surgery.

Objective Observe the efficacy and safety of glucocorticoid deescalation combined antiviral therapy on severe hepati‐tis B .Methods Forty‐nine patients with early severe hepatitis were selected and divided them into observation group(n=24) and control group (n=25) randomly .Control group were given the conventional synthetic therapy while observation group were given conventional synthetic therapy combined glucocorticoid deescalation therapy .Then compare the differences of TBIL ,ALT ,PTA be‐fore and after treatment ,and the improvement time of syndrome and death rate between two groups .Results The death rate in ob‐servation group and control group were 16 .7% and 32 .0% respectively(P<0 .05) ,the improvement time of syndrome in observa‐tion group were shorten than control group(P<0 .05) ,and there was no statistical difference in bleeding and infection rate between two groups(P>0 .05) .After the treatment ,the TBIL ,ALT ,PT were improved in both two groups(P<0 .05) .But the observation group had better improvement than control group ,the difference had statistical significance(P<0 .05) .After treatment ,the changes of HBV DNA between two groups showed no significant difference(P> 0 .05) .Conclusion Glucocorticoid deescalation therapy could decrease the death rate ,shorten the syndrome lasting time in treating severe hepatitis B .It was an effective and safety meth‐od .