Urinary tract infections (UTIs) are common, recurrent infections that can range from mild to life-threatening. High recurrence rates of UTIs and increasing antimicrobial resistance may place a greater financial burden on the patients with UTIs. Thus, UTIs is becoming an increasingly serious public health problem. This review summarized how pathogens adhered to and colonized host cells, the important role of bacterial pili in the development of UTIs and the pathogenic mechanisms of different pathogens in UTIs and catheter associated urinary tract infections (CAUTIs). Elucidating the molecular mechanisms of host-pathogen interactions and the pathophysiological consequences of these interactions in UTIs is conducive to further understand the pathogenesis of UTIs.

Objective To investigate the prevalence and the related factors of female breast disease in Zhengzhou City, Henan Province, and to provide a targeted prevention guide for female breast disease. Methods A total of 6310 women were enrolled in this study. In addition to breast ultrasound, mammography and pathology assays were performed. Finally, the prevalence and influencing factors for female breast disease were analyzed. Results The prevalence of breast cancer and the total prevalence of breast diseases was 0.06% and 24.94%, respectively. The prevalence of female breast diseases was significantly correlated to age, educational level, occupa-tion, menstruation, reproductive age and a history of abortion. Logistic regression analysis showed that the occupa-tional type had a significant effect on the prevalence of female breast. Conclusion The prevalence of female breast disease is relatively high in Zhengzhou City, and it is affected by many factors. The targeted surveys and breast dis-ease screening should be conducted, and the secondary prevention of female breast disease should be strengthened.

Objective To analyze the relationship between polymorphisms of EDNRB gene and Hubei provincial patients of Han ethnicity with sporadic Hirschsprung disease(sHD). Methods Peripheral blood samples from 104 patients with sHD and 84 parents of 42 patients, and 120 normal children(as controls) were collected. PCR-SSCP and direct DNA sequencing were used to detect mutations and polymorphisms of exon-4 in EDNRB gene. The differences of allele frequencies and genotype distribution in polymorphic sites were further analyzed between the three groups. Allele frequencies of SNPs in forty-two sHD trios were analyzed by transmission disequilibrium test(TDT), and the association between phenotype of HD and SNPs was analyzed. Results No mutant site was detected and one polymorphic site of c831 G→A(L277L) was observed in Hubei provincial patients of Han ethnicity with sHD. The allele frequency of A(68% vs 53%) and genotype frequency of AA(49% vs 30%) were significantly higher in sHD group than that in control group(P

Objective To review our clinical experience with 41 reoperatioas of prosthetic heart valve dysfunction be-tween October 1996 and October2008. Methods There were 16 malas and 25 females with an average age of (44.5±12.6)years. All 41 patients underwent reoperation under hypothermic cardiopulmonary bypass, including 38 heart valve replace-ments, 2 disc rotations and cut of the excessive knot in 1 case. There were 13 emergency and 28 elective procedures. Results The median time for extubation was 15.3 hours and tracheostomy was needed in 5 cases. There were 6 deaths, all of which occurred in emergency cases, with a mortality rate of 15.4%. No death occurred in patients implanted with a bioprosthetic valve previously. Postoperative complications included 1 infective endocarditis, 1 intractable hiccup and 1 wound infection. Conclusion Prosthetic heart valve dysfunction is catastrophic. Early diagnosis and reoperation is mandatory.

Objective Summarizing single clinical experience with extracorpomreal membrane oxygenation(ECMO) as a supplement to extracorporeal cardiopulmonary resuscitation(ECPR) in adult patients with cardiac arrest to explore new ideas.Methods We retrospectively analyzed the characteristics of 17 patients who underwent ECMO as part of ECPR from July 2005 to September 2014 at Fuwai Hospital,and analyzed the differences between the survival group(n =6) and the in-hospital death group.Results The mean CPR time was(44.53 ± 21.39) min.The support duration of ECMO was(106.38-± 70.43) h.12 patients of all were successfully weaned from ECMO,and 6 patients survived to hospital discharge.There were significant differences between the two groups in terms of the last serum creatinine and blood lactate acid level before ECMO,and the time to lactate normalization.11 patients died,7 patients developed bleeding,and 8 cases developed infection.Conclusion Single-center data showed that applying ECMO as a means of ECPR improved the survival rate in cardiac arrest patients.Additionally,creatinine and lactic acid were good indicators for assessing prognosis.Refractory circulatory dysfunction and neurologic complications have an adverse impact on the survival of cardiac arrest patients.

Objective To analyze the risk factors for in-hospital mortality in patients aged over 65 years undergoing heart valve surgery combined with coronary artery bypass grafting(CABG).Methods Between February 2002 and September 2014,540 patients aged over 65 years undergoing heart valve surgery combined with CABG in our institute were retrospectively studied.Univariate analyses and multivariate logistic regression analyses were performed to explore risk factors associated with in-hospital mortality.Results Overall in-hospital mortality was 4.26％.Univariate analysis depicted that chronic obstructive pulmonary disease (COPD) (P =0.001),last serum creatinine (P =0.043),unstable angina(P =0.046),Canadian Cardiovascular Society 111-ⅣV (P =0.005),number of diseased coronary vessels (P =0.043),cardiopulmonary bypass time-delayed (P =0.003),post-operative morbidity (P =0.000) had a significant impact on in-hospital mortality.Multivariate logistic regression analysis revealed that COPD (P =0.005,OR =5.598),CPB time-delayed (P ＜ 0.001,OR =1.011),re-exploration (P ＜0.001,OR =15.813),malignant arrhythmia (P =0.014,OR =4.900) were independent risk factors of in-hospital mortality.Conclusion The present research demonstrates that COPD,CPB time-delayed,re-exploration and malignant arrhythmia dramatically impacted the in-hospital mortality of patients aged over 65 years undergoing combined heart valve surgery and CABG.

Objective: Based on nationwide cardiovascular surgery registry database, to analyze the current status and future development of minimally invasive cardiovascular surgery (MICS) in China.
Methods: There were 45 institutions from 19 provinces nationwide involved in Chinese cardiovascular surgery technique registry study. A total of 16480 adult patients with cardiovascular surgery from 2010-09 to 2012-03 were divided into 2 groups, Conventional surgery group, n=14503 and MICS group, n=1977. The basic clinical conditions were analyzed and compared between 2 groups in order to explore the current status and future development of MICS in China.
Results: Compared with Conventional surgery group, the patients in MICS group had the younger age, better and stable pre-operative condition. In MICS group, compared with 4 other common procedures, the patients who received hybrid procedure had obviously shorter cardiopulmonary bypass (CPB) time, aortic occlusion time, ventilator using time, ICU and in-hospital stay time, meanwhile decreased post-operative drainage volume;except for Robotic surgery, it required less red blood cells and plasma at during and post-operative time, all P<0.01. There were 12 (0.6%) in-hospital death in MICS group, the total complication rate was at 4%.
Conclusion: MICS are widely used in China, its short-term safety and efifcacy are conifrmed. Upon cardiovascular disease spectrum changing, the MICS procedures will be adjusted accordingly.

Objectives: To analyze clinical characteristics with the early and late prognosis in elder patients with combined aortic valve replacement (AVR) and coronary artery bypass grafting (CABG).
Methods: A total of 232 patients≥65 years of age who received AVR-CABG in our hospital from 2004-02 to 2014-09 were retrospectively analyzed. The risk factors affecting the early and late prognosis in those patients were studied by multivariate Logistic regression analysis and Cox proportional hazards model.
Results: The in-hospital death happened in 7/232 (3.0%) patients, early post-operative complication with prolonged mechanical ventilation time was 28 (12.1%) and bleeding was 14 (6.0%). The follow-up study was conducted in 225/232 (97.0%) survived patients from 3 months to 10 years at the mean of (41.2 ± 29.0) months; 6 (2.7%) patients had cardiac death, the major late post-operative adverse events were cardiac dysfunction (III to IV) or recurrence of angina (8.9%). Multivariate Logistic regression analysis revealed that female (P=0.019, OR=2.576), pre-operative atrial ifbrillation (AF) (P=0.012, OR=3.541) and CPB time (P=0.000, OR=3.781) were the independent risk factors affecting early post-operative outcome. Cox proportional hazards model presented that hyperlipidemia (P=0.025, HR=2.535), smoking (P=0.009, HR=3.414) and the history of PCI (P=0.013, HR=3.562) were the independent risk factors inlfuencing late prognosis of AVR-CABG.
Conclusion: The overall effect of AVR-CABG in elder patients was satisfactory. Female, pre-operative AF, CPB time may affect the early post-operative outcome, while hyperlipidemia, smoking and PCI history could inlfuence the long-term prognosis in relevant patients.

ObjectiveTo assess the prognostic efficiency of three different risk socres in patients underwent redo-coronary artery bypass grafting (redo-CABG).MethodsFrom January 1997 to July 2011,57 patients underwent redo-CABG in Fu Wai Hospital.All patients were prospectively scored for operative mortality using EuroScore,STS Score and Sinoscore.The overall expected mortality were compared with the observed mortality.Discrimination was evaluated by receiver operating characteristic (ROC) cures and area under a ROC curve (AUC).ResultsFour patients died in the whole group,the observed mortality was 7％.The overall predicted mortality of EuroScore,STS Score and SinoScore were 5.6％,2.2％ and 1.5％,all lower than the observed mortality.The AUC of the three kinds of score were respectively 0.495,0.557 and 0.535,which indicated that the discrimination of the three kinds of score are poor.ConclusionThe predictive value of EuroScore,STS Score and SinoScore for early postoperative mortality in patients undergoing redo-CABG is poor.Surgical technology is an important predictor for early postoperative mortality.

Objective To report therapeutic effects of patients with bladder cancer treated by intra-operative radiation and to recommend an effective method for the treatment of bladder cancer.Methods During the operation,when the tumor of bladder had been removed,a boost dose of electric beam from a linear accelerator was irridiated to the tumor bed.28 cases were follawed-up in a long period.Results Lower local recurrence was observed in patients received intra-operative radiation therapy,only 2 cases had a small recurrent tumor in the bladder during the follow-up period.26 cases had bean followed up,no tumor recurred.Conclusion The intraoperative radiation therapy is a useful treatment for the bladder cancer.