Bladder pain syndrome or interstitial cystitis (BPS/IC) is a clinical diagnosis based primarily on refractory suprapubic pain,which is lack of effective treatment and a broad consensus of diagnostic criteria,because its etiology and pathophysiology remains unclear.In this review,it was discussed that recent research advancement regarding to definition,etiology,diagnosis and treatment of BPS/IC,through referring to the latest guidelines and literature on this disorder.

Objective To study the effect of autologous bone marrow mesenchymal stem cells in the treatment of osteonecrosis .Methods 56 cases of osteonecrosis of femeral head ( ONFH) were treated with autologous bone marrow mesenchymal stem cells .DSA observed neovascularization after transplantation ,morphological changes of femoral head were observed by imaging method .Results Of the 30 patients who underwent autologous bone marrow stem cell transplantation,86.6％had resuscitation of hip pain,23.3％ had improved hip function,and 85.7％ had walking distance .Examination showed that the arterial artery was significantly increased before transplantation , thickening,faster blood flow.The femoral head area of the bone was significantly improved (100.0％) after 12 -24 months.Conclusion The method of transplantation of bone marrow mesenchymal stem cells is simple ,safe and effective.It is effective for stage I and II of the avascular necrosis of the femoral head .

Objective To explore the curative effect and complication of transcutaneous transcatheter uterine arterial embolization in the treatment of postpartum hemorrhage .Methods 76 cases with postpartum hemorrhage of conservative treatment invalid in the General Hospital of Huainan Oriental Hospital Group from January 2011 to January 2017 , received digital subtraction angiography ( DSA ) to make clear the site of hemorrhage , then bilateral uterine artery embolization was given .Results Seventy -six patients have stopped bleeding immediately after embolization,3 cases were significantly reduced .Bleeding stopped completely after nearly one week of treatment .Mild fever after embolization appearred unable to pain in the lower abdomen ,1 case had hip pain .Conclusion Transcuta-neous transcatheter uterine artery embolization in the treatment of postpartum hemorrhage has advantages of quick hemostasis,less trauma,less complications and preserving the uterus fertility ,which has high clinical value .

Objective To characterize the urinary microbial profile of male non-muscle invasive bladder cancer patients compared to healthy controls.Methods Between March,2017 and September,2017,mid-stream urine from 26 non-muscle invasive bladder cancer and 18 non-neoplastic controls were collected by the clean method,then centrifuged and processed for 16S rRNA gene sequencing.Sequencing reads were processed for evaluating alpha diversity and beta diversity using QIIME.LEfSe algorithm was performed to identify potential bacterial genera biomarker.Results The smoking cases were more in tumor group than those in control group(21 vs.7,P ＜ 0.01).The urinary microenvironment of bladder cancer was characterized by increased bacterial richness (Observed species index,Chaol index and Ace index,125.77 ± 69.64 vs.80.38 ± 46.24;142.82 ± 76.74 vs.90.68 ± 47.62;and 147.92 ± 77.68 vs.88.19 ± 45.38,all P ＜ 0.05) and by the enrichment of some bacterial genera (e.g.,Acinetobacter and Anaerococcus).Significant difference in β diversity was found between cancer and non-cancer group (ANOSIM,P =O.009).A clear hierarchical clustering of cancer samples was observed,suggesting a common dysbiosis associated to bladder cancer.Conclusions Patients with non-muscle invasive bladder cancer exhibit a different microbial community compared to non-neoplastic controls,suggesting a possible pathophysiological correlation between microbiome and bladder cancer.Urinary microbial community may be associated with the prognosis of NMIBC.

Objective To characterize the female urinary microbiome associated to OAB (overactive bladder) and investigate relationships between urinary microbiome and psychological factors.Methods 30 women with OAB and 25 asymptomatic controls were recruited and required to finish the overactive bladder symptom score,self-rating anxiety scale,self-rating depression scale and quality of life questionaires.Urine specimens were collected by transurethral catheterization and processed for 16S rRNA gene sequencing.Sequencing reads were processed using QIIME.Analyses for bacterial genera biomarker was used LEfSe algorithms.Bivariate correlations were assessed using Pearson's correlation.Results The two cohorts showed no significance difference in their demographic characteristics.OAB patients had significantly higher scores on overactive bladder symptom score,self-rating anxiety scale,self-rating depression scale and quality of life than controls (P ＜ 0.001).We found that bacterial diversity (Chao1 index:1 854.09 ± 1 239.34) and richness (Simpson index:0.75 ±0.23) were decreased in OAB samples than those of controls (Chao1 index:2 866.27 ± 1 795.22;Simpson index:0.86 ± 0.12;P =0.02).At the family level,Enterobacteriaceae and (17.6％ vs.8.1％;P =0.03) Bifidobacteriaceae (14.8％ vs.3.6％;P =0.01) were significantly more abundant in the OAB samples than the controls.Compared to controls,7 genera increased in OAB patients (e.g.,Proteus and Aerococcus) and 13 reduced (e.g.,Lactobacillus and Prevotella).There are negative correlations between scores on Self-Rating Depression Scale and both Chao1 (r =-0.458,P =0.011) and shannon indexes (r =-0.516,P =0.003) in OAB patients,which indicates that OAB patients with depression have further reductions in bacterial diversity and richness.Conclusions The aberrant urinary microbiome may serve as disease biomarkers and potential therapeutic targets of OAB.A negative correlation between depression scores and both bacterial richness and diversity in OAB patients indicated that there might be a connection between central nervous system and urinary microbiome.

Objective To explore the relationships among the central nervous system,the lower urinary tract and urinary microbiome by a rat model of stress-induced voiding dysfunction.Methods Rats were randomly assigned to stress group (exposure to water-avoidance stress for 10 days),stress-withdrawal group (exposure to the stress and then withdrawal for 2 weeks) or control group.On day 11 for stress and control groups or 2 weeks after day 11 for stress-withdrawal group,the Light-dark box transition test,lower abdominal pain threshold,micturition frequency and cystometry measurements were determined.Urine specimens were collected and processed for 16S rDNA gene sequencing.Results Compared to control group,the water-avoidance stress dramatically decreased in the time spent in the light area (P ＜0.01) and decreased mechanical pain threshold in stress group,which were reversed in stress-withdrawal group.While there was no significant difference in the micturition frequency between the control and stress-withdrawal groups,the stress group (20.33 ± 3.77) showed significantly more micturition frequencies than control (8.14 ± 2.23) and stress-withdrawal group (9.67 ± 1.89) (P ＜ 0.01).The stress dramatically increased voiding contractions in both the stress (7.33 ± 1.79) and stress-withdrawal (4.83 ± 1.06) groups compared to control rats (2.71 ± 1.38) (P ＜ 0.05).However,the stress-withdrawal group showed less voiding contractions than the stress group (P =0.03).The bacteria diversity in stress group were dramatically higher than those of the other two groups (P ＜ 0.01).Almost all specimens of the control rats were dominated by Enterococcacae,whereas samples from the stress group contained more diverse bacteria.The diversity of microbiota in the stress-withdrawal group was between those of the other two groups.LEfSe identified genera differed significantly among groups:Lactococcus and Proteus were significantly increased in in the stress-withdrawal group;Halomonas,Aggregatibacter,Haemophilus,Pseudomonas and Streptococcus were significantly higher in the stress group.Conclusions Water-avoidance stress experiments demonstrated the impact of stress on bladder function and urinary microbiome,which tended to be ameliorated after a two-week withdrawal from stress.Further research is needed to understand the connections between central nervous system,bladder and urinary microbiome.

Objective Bladder filling in patients with cervical cancer before and after operation during intensity-modulated radiotherapy (IMRT) was controlled by using bladder volume measurement instrument (BVI 9400).The displacement errors of the target area and the changes of the irradiation dose and the morphology of the filling bladder were compared.The significance of consistency of preoperative and postoperative bladder filling in IMRT for cervical cancer was investigated.Methods Forty-five patients with cervical cancer treated with radiotherapy in our hospital in 2018 were recruited and divided into A,B and C groups (n=15).In group A,patients did not undergo surgery,patients in group B received radical resection of cervical cancer (bladder volume measurement (BVI 9400) was utilized to monitor the bladder urine volume in both A and B groups before treatment).In group C,patients who self-controlled urination without monitoring bladder urine volume before treatment were randomly selected.All patients in three groups underwent KV-CBCT scan before treatment for online registration analysis.The displacement errors in the x-(left and right),y-(head and foot),z-axis directions (ventral and dorsal),PTV coverage volume percentage (V10o) and percentage difference (△ V100) of the prescription dose were calculated.Results The average displacement errors in the x-,y-,z-axis directions were as follows:1.67 mm,1.55 mm and 1.67 mm in group A,1.43 mm,1.58 mm and 1.84 mm in group B,and 2.27 mm,2.30 mm and 2.08 mm in group C,respectively.In group A,the V1oo was calculated as 96.96％ and △ V1oo was 1.17％.In group B,V1oo was 9 5.9 ％ and △ V10o was 1.2 9 ％.In group C,V10o was 9 4.0 2 ％ and △ V100 was 2.1 7 ％.Conclusions Controlling the consistency of bladder filling can reduce the effect of inconsistency of bladder filling upon the displacement errors to certain extent,which can guarantee the accuracy of the target location and the irradiation dose of the target,protect the bladder,small intestine and rectum,and alleviate the radiation-induced response of cervical cancer patients.

Objective To investigate the effect of bilateral internal iliac artery balloon occlusion in cesarean section for dangerous placenta previa and placenta implantation.Methods From January 2011 to December 2016,The clinical data of 15 cases of dangerous placenta previa and placenta implantation were retrospectively analyzed in the General Hospital of Huainan Oriental Hospital Group.All patients underwent internal iliac arterial intubation prior to cesarean section and into the balloon,placed the balloon in the bilateral internal iliac artery,and filled the balloon to temporarily block internal iliac arterial blood flow.The number of hysterectomy cases of cesarean sections were recorded.Results The amount of intraoperative hemorrhage was about 200-4 000mL,average 1 500mL.Intraoperative,postoperative red blood cell was 0-3 000mL,average 1 000mL,there were no maternal and fetal death and serious complications,2 cases in hysterectomy,the resection rate was 10.8％.Conclusion Bilateral internal iliac arterial balloon occlusion can effectively control the bleeding of the dangerous placenta previa during cesarean section and reduce the hysterectomy.The radiation dose is safe for the fetus.

Pancreaticoduodenectomy is one of the most difficult abdominal operations, and the difficulty in resection and complicated digestive tract reconstruction have brought great challenges for surgeons. At present, laparoscopic pancreaticoduodenectomy has been widely used in clinical practice, and compared with traditional 2D laparoscopy, 3D laparoscopy has the features of high magnification, high definition, and three-dimensional vision, which enables surgeons to see more clearly and operate more accurately, and thus it has great potential to be widely used in pancreaticoduodenectomy.

Objective:To examine the surgical approach, practical cognition as well as clinical effect of the orthotopic resection for laparoscopic pancreatoduodenectomy(OLPD).Methods:From March 2019 to December 2019, 32 cases were treated with laparoscopic pancreatoduodenectomy (LPD) in a novel approach without mobilization of pancreatoduodenum in Pancreas Center of the Second Affiliated Hospital of Guangzhou University of Chinese Medicine.There were 16 male patients and 16 female patients.The mean age was (64.8±9.5) years old.Body mass index was 14.9 to 31.0 kg/m 2.All patients were diagnosed as ampullary or pancreatic head tumors and were not unresectable cases.In the surgical strategy, Kocher′s dissociation, turning and pulling of the pancreaticoduodenal region, was not performed first.Anatomy in situ, separation of vessels which enter and exit from pancreas, separation of lymphatics and isolation of tumors were carried out in priority through the combined middle and left posterior approaches.Finally, the pancreatic head and duodenum region was mobilized and the entire resection of pancreas in situ was carried out.Digestive tract reconstruction was performed through Child method. Results:Postoperative pathology showed that 27 cases were pancreatic or ampullary malignant tumors and five cases were benign tumors among 32 patients.The operative time was (357.3±64.3) minutes.The diameter of pancreatic ducts was (3.0±1.0) mm. The pancreas of 20 cases (62.5%) were soft. Five patients suffered from pancreatic fistula (Grade B) and one patient suffered from intra-abdominal hemorrhage postoperatively.No other complications like pancreatic fistula (Grade C) or biliary fistula delayed gastric emptying or mortality were encountered.The postoperative hospital day was (13.7±3.6) days.Conclusions:Combining the multi-angle of the laparoscopic approaches and excising the pancreaticoduodenal specimen in situ, OLPD is a kind of surgical method which can realize the concept of no touch tumor surgery.Patients who undergo the OLPD can receive better treatments and results.