Needle-free injection technology (NFIT) refers to the drug delivery systems in which drugs are propelled as high-speed jet streams using any of the pressure source to penetrate the skin to the required depth. NFIT is a promising drug delivery system as it enables the injection of liquids, powders, and depot/projectiles, and has the advantages of preventing needle stick accidents, improving drug bioavailability, eliminating needle-phobia, increasing vaccine immunity, simplifying operations and is convenient for patients to use. NFIT and its research background, the structure and classification of needle-free jet injectors (NFJI), drugs that can be delivered using NFJI and the factors affecting the injection effect are comprehensively reviewed in this paper. The limitations and potential development directions are summarized to provide a theoretical basis for the application and development of NFIT.

OBJECTIVE: To compare the effects of normal-pressure drainage (norPD) and negative-pressure drainage (negPD) after laparoscopic radical prostatectomy (LRP) in the treatment of PCa. METHODS: We retrospectively analyzed the clinical and follow-up data on 87 cases of PCa treated by LRP from October 2019 to October 2022, 46 receiving norPD and the other 41 negPD postoperatively. We indwelt an F20 pelvic drainage tube for each of the patients, which were connected to an anti-reflux drainage bag for those in the norPD group and a 200 ml negative pressure ball for those in the negPD group, and removed the tubes at the drainage volume ≤30 ml/d. We compared the operation time, intraoperative blood loss, drainage volume on the first day after surgery, total postoperative drainage volume, drainage tube-indwelling duration, drainage tube-related nursing time, urinary catheter removal time, wound healing time, and incidence of postoperative complications between the two groups of patients. RESULTS: No statistically significant differences were observed between the two groups in terms of operation time, intraoperative blood loss, wound healing time, and postoperative complications (P>0.05). The drainage volume on the first postoperative day and the total postoperative drainage volume were significantly lower, and the drainage tube-indwelling duration and drainage tube-related nursing time markedly shorter in the norPD than in the negPD group (all P<0.05). CONCLUSION Normal-pressure drainage is a safe and effective drainage method after laparoscopic radical prostatectomy, which can significantly reduce the postoperative drainage volume, drainage tube-indwelling duration and drainage tube-related nursing time.
Humans ; Male ; Prostatectomy/methods* ; Laparoscopy ; Prostatic Neoplasms/surgery* ; Drainage/methods* ; Retrospective Studies ; Postoperative Complications ; Middle Aged ; Operative Time

【Objective】 To evaluate the clinical characteristics and survival of patients with rare clear cell papillary renal cell carcinoma (ccpRCC). 【Methods】 Clinical data of ccpRCC cases treated during 2016 and 2019 were analyzed, clinical characteristics were described, and survival was analyzed using the Kaplan-Meier method. 【Results】 In the SEER database, 191 ccpRCC cases with complete clinical data and positive histology were retrieved, including 112 males (58.7%) and 79 females (41.3%), 136 Grade 1-2 (71.2%) cases and 19 Grade 3-4 (10.0%) cases, 174 stage T1 (91.1%) cases and 17 stage T2-3 (8.9%) cases. Distant metastasis (lung metastasis combined with lymph node involvement and major vein involvement) occurred in one case, and vein tumor thrombosis occurred in two patients. Surgery especially radical nephrectomy and partial nephrectomy was performed in 181 patients (94.8%). One patient died due to recurrence, and 4 due to other causes. The 12-month and 24-month survival were 98.5% and 97.4%, respectively. 【Conclusion】 Patients with ccpRCC have low clinical stage and histological grade, minimal tumor progression and distant metastasis, good prognosis and extremely low disease-specific mortality. Radical nephrectomy and partial nephrectomy have significant therapeutic effects.

Objective:To analyze the etiological characteristics and molecular epidemiological correlation of five cases of typhoid fever during the same period in yantai city.Methods:Six S. Typhis strains were isolated from 5 typhoid patients and epidemiological samples in Yantai city in 2018. The onset time of the cases were from May 26, 2018 to July 24, 2018, distributed in Shuidao Town of Muping District, Dengzhou Street of Penglai District, Donglai Street of Longkou District, Wenhua Street of Muping District and Fulaishan Street of zhifu District. S. Typhis strains were analyzed by conventional bacterial isolation method and XbaⅠ/BlnⅠ double-enzyme digestion pulse-field gel electrophoresis (PFGE). Meanwhile, ViaB virulence gene detection and 27 common antibiotics sensitivity tests were conducted to study the etiology of S. Typhis.Results:Six strains of S. Typhi were isolated from 5 patients and the domestic egg of one patient, which were divided into 4 PFGE patterns by PFGE-XbaⅠ and PFGE-BlnⅠ and among which 3 strains had the same PFGE patterns.One multi-drug resistant strain (foreign patient), one single-drug resistant strain (patient with a history of provincial retention), and one completely sensitive strain were detected. The three strains of the same PFGE pattern exhibit the same drug-sensitive phenotype which were intermediate against aminoglycosides and quinolones and susceptibility against the other antibiotics.All of the strains carried the ViaB virulence factor except the strain from the foreign patient.Conclusion:Local S. Typhi is susceptibility or intermediate against antibiotics commonly used in clinic.Sporadic cases of typhoid fever and typhoid imported infections still need attention.

Objective:To analyze the etiological characteristics and molecular epidemiological correlation of five cases of typhoid fever during the same period in yantai city.Methods:Six S. Typhis strains were isolated from 5 typhoid patients and epidemiological samples in Yantai city in 2018. The onset time of the cases were from May 26, 2018 to July 24, 2018, distributed in Shuidao Town of Muping District, Dengzhou Street of Penglai District, Donglai Street of Longkou District, Wenhua Street of Muping District and Fulaishan Street of zhifu District. S. Typhis strains were analyzed by conventional bacterial isolation method and XbaⅠ/BlnⅠ double-enzyme digestion pulse-field gel electrophoresis (PFGE). Meanwhile, ViaB virulence gene detection and 27 common antibiotics sensitivity tests were conducted to study the etiology of S. Typhis.Results:Six strains of S. Typhi were isolated from 5 patients and the domestic egg of one patient, which were divided into 4 PFGE patterns by PFGE-XbaⅠ and PFGE-BlnⅠ and among which 3 strains had the same PFGE patterns.One multi-drug resistant strain (foreign patient), one single-drug resistant strain (patient with a history of provincial retention), and one completely sensitive strain were detected. The three strains of the same PFGE pattern exhibit the same drug-sensitive phenotype which were intermediate against aminoglycosides and quinolones and susceptibility against the other antibiotics.All of the strains carried the ViaB virulence factor except the strain from the foreign patient.Conclusion:Local S. Typhi is susceptibility or intermediate against antibiotics commonly used in clinic.Sporadic cases of typhoid fever and typhoid imported infections still need attention.

Objective:To measure the space of motion of index finger with and without injury, to apply it in rehabilitation. Methods:Thirty healthy undergraduate volunteers (controls) and three undergraduate volunteers with recent index finger injury (patients) were asked to flex, extend, adduct, abduct and ring the index finger independently and combined with middle finger, twice for a motion with an interval of 30 seconds. The index finger movement trajectory was recorded with a high-definition camera, and analyzed the range of flexion, extension, adduction, abduction and ring rotation motion with MATLAB. The movement space and defect of the injured fingers were drawn. Results:The ranges of independent flexion-extension and adduction-abduction reduced 26.5% and 24.6% in the patients compared with those of the controls, respectively. The defects of ring rotation space were very different with the degrees of recovery, and the maximum loss happened on 160°, 70° and 170°. Conclusion:Loss in index fingers motion space in range and direction may help for rehabilitation assessment.

Destruction of blood-brain barrier (BBB) is one of the important pathological changes after traumatic brain injury (TBI).Early detection of TBI evaluate and prognosis of TBI patients are of great significances. Monitoring of changes in BBB after TBI have been more and more emphasized in clinical practice. The pathophysiological changes of BBB after TBI and research progresses of MR perfusion weighted imaging (PWI) in TBI were reviewed in this article.

Objective]Study on the etiology and pathogenesis of exogenous diseases of Treatise on Seasonal Diseases. [Methods]Using the history of Traditional Chinese Medicine method, traditional Chinese medicine philological method and theoretical analysis method.[Results]The exogenous diseases were divided into instant diseases and incubated diseases by Lei Feng. He pointed out that the pathogenic evils hidden in the weak place. Pathogenic evils lurk in the internal and external causes. Different pathogenic evils are hidden in different position. There are three different forms of the attack of incubated disease. [Conclusion]Lei Feng's study on the etiology and pathogenesis of exogenous disease, especially the attack of incubated disease, has certain reference value for today's treatment of the Traditional Chinese Medicine of exogenous diseases.

ObjectiveTo study the clinical effect endoscopic realignment with drainage via a peel-away sheath in the treatment of urethral rupture.

METHODSWe treated 21 urethral rupture patients by endoscopic realignment with drainage via a peel-away sheath using normal saline for irrigation under the normal nephroscope or Li Xun nephroscope, followed by analysis of the clinical results.

RESULTSThe operation was successfully accomplished in 20 cases but failed in 1 and none experienced urinary extravasation. In the 14 cases of bulbar urethral rupture, the mean operation time was (5.1±1.6) min and the mean Foley catheter indwelling time was (26.0±5.1) d. Urethral stricture developed in 57.1% (8/14) of the cases after catheter removal, of which 1 was cured by internal urethrotomy and the other 7 by urethral sound dilation, with an average maximum urinary flow rate of (18.8±1.8) ml/s at 12 months after operation. In the 6 cases of posterior urethral rupture, the mean operation time was (15.8±7.5) min and the mean Foley catheter indwelling time was 8 weeks. Urethral stricture developed in all the 6 cases after catheter removal, of which 3 cases were cured by urethral dilation, 1 by internal urethrotomy, and 2 by open urethroplasty. The average maxium urinary flow rate of the 4 cases exempt from open surgery was (17.9±1.9) ml/s at 12 months after operation.

CONCLUSIONSEndoscopic realignment with drainage via a peel-away sheath can keep the operative field clear, avoid intraoperative rinse extravasation, shorten the operation time, improve the operation success rate, and achieve satisfactory early clinical outcomes in the treatment of either bulbar or posterior urethral rupture.

Device Removal ; Drainage ; Endoscopy ; Humans ; Operative Time ; Rupture ; surgery ; Treatment Outcome ; Urethra ; injuries ; Urethral Stricture ; etiology ; Urinary Catheterization

OBJECTIVETo evaluate the feasibility and safety of the modified urethral pull-through procedure for the treatment of posterior urethral stricture or atresia.

METHODSWe retrospectively analyzed 212 cases of posterior urethral stricture or atresia treated by the modified urethral pull-through procedure. The length of the stricture or atresia was 1.5 - 12 cm, and 66 cases had experienced 1 - 4 previous unsuccessful urethral repairs. Simple transperineal approach was adopted in 208 cases and transperineal-inferiorpubic approach in the other 4. And 15 of the patients underwent urethral construction with grafts.

RESULTSSatisfactory voiding was achieved in 198 (93.4%) of the patients, of whom 16 received 3 - 15 urethral dilations. Of the 14 cases that failed, 10 succeeded after a second and 2 after a third operation. Of the 15 cases that underwent substitution urethroplasty, 14 achieved satisfactory voiding, and only 1 needed repeat dilation. No serious complications were observed in any of the patients.

CONCLUSIONModified urethral pull-through procedure, with its advantages of safety, mini-invasiveness, simple operation and high success rate, is feasible for the treatment of posterior urethral stricture or atresia, while for that with the length >5 cm, substitution urethroplasty should be considered.

Adolescent ; Adult ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Urethra ; surgery ; Urethral Stricture ; surgery ; Urologic Surgical Procedures ; methods ; Young Adult