A middle-aged lady was treated and followed up for recurrent urinary tract infections (UTI) with increasingly resistant organisms without documentation of interval resolution of infection by negative urine cultures. We discuss the events following the diagnosis of her fourth urinary tract infection. Referral for further evaluation of her urinary tract in view of recurrent UTI showed she had a bladder cancer. The investigation and management of recurrent UTI is reviewed. The link between bladder cancer and recurrent urinary tract infection is also explored.

Objective To investigate the curative effect and adverse reaction of caffeic acid (CFA) for leukopenia and thrombocytopenia caused by imatinib in chronic myeloid leukemia (CML) patients.Methods The effect and adverse reactions of CFA for leukopenia or thrombocytopenia induced by imatinib in 42 CML patients were observed.The CFA was admitted by 0.2 g/time,3 times/d,oral.Results 21 cases of 42 CML patients with thrombocytopenia achieved remarkable curative effect after CFA treatment,13 achieved good effect and 8 had no effect.The total effective rate was 81.0 ％ (34/42).While 15 of 28 leukopenia CML patients achieved remarkable curative effect,8 achieved good effect and 5 had no effect.The total effective rate was 82.1％ (23/28).After CFA therapy for 2 weeks,both platelet and white blood cells count were elevated compared with before treatment,the differences were statistically significant (t =2.015,P =0.023,t =1.913,P =0.035).The average onset time of CFA for leukopenia and thrombocytopenia was 2 weeks and no treatment-related adverse reaction was found.Conclusion CFA is an effective and safe auxiliary drug for treatment of imatinib-induce leukopenia and thrombocytopenia in patients with CML.

Objective To evaluate the arc renal parenchyma incision of pelvis within renal sinus and renal posterior lib for the removal of complex staghorn renal calculi.Methods Arc renal parenchyma incision of pelvis within renal sinus and renal posterior lib was performed to remove stones in 86 cases (97 sides) with complex staghorn renal calculi.Among the 86 cases,42 had stones on the right side;33,on the left side;11,on bilateral sides.Seventeen cases had concomitantly calculi in the ureter,and 54 had calculi in upper and mid calyx or multiple renal calculi.As for comorbidity,11 cases had hypertensions;4,diabetes; and 5,hepatitis B.Twenty-five cases had renal insufficiency,with BUN of 12.3 -76.0mmol/L and Cr of 231 -1721?mol/L.The procedure was performed as follows:the kidney was dissected free and the pelvis within renal sinus was isolated.Two rows of bottom style sutures were made on the renal parenchyma with 2-0 plain catgut along mid-lower 1/3 of the dorsal surface of kidney free of vessels from the renal posterior lib to the plane of lower major calyx.The renal parenchyma was opened.Then,the incision was developed from the plane of lower through the middle major calyx to the plane of upper major calyx.The renal parenchyma and mid-low calyx along the incision were opened,suturing while incising,so that all the stones could be easily removed with hook.Results The calculi were completely removed in all 86 cases (97 sides).The opera- tive time was 105-187min ( mean,129min).The intraoperative blood loss was 120-460 ml ( mean,220 ml).Forty-three cases needed intraoperative blood transfusion of 120 -200 ml (mean,140 ml).One month after operation,KUB+IVU and ultrasonic findings were normal with improved hydronephrosis,no intrarenal stricture and no residual calculi.Conclusions This procedure has the advantages of less bleeding,slight impairment of renal function,simple handling,clear operative field,high clearance rate,therefore is indica- ted for the removal of complex staghorn calculi.

Objective To investigate the therapeutic effects and side effects of FLAG and MEA regimen in the treatment of relapsed and refractory adult acute myeloid leukemia.Methods Use retrospective analysis to Observe the therapeutic effects and side effects of the 51 cases of relapsed and refractory adult acute myeloid leukemia (M3 except) from January 2009 to June 2012 in our hospital,which are divided into FLAG group (23 cases) and MEA group (28 cases) according to chemotherapy.Results In FLAG group,the rate of complete remission was 30.4 ％ (7/23),the rate of partial remission was 17.4 ％ (4/23),the effective rate was 47.8 ％ (11/23).In MEA group,the rate of complete remission was 35.7 ％ (10/28),the rate of partial remission was 21.4 ％ (6/28),the effective rate was 57.1％ (16/28),difference between two groups was not statistically significant. Both groups appeared Ⅳ degrees myelosupression,and there were no significant differences between them on incidences of secondary infection [95.7 ％ (22/23) vs 89.3 ％ (25/28)] and haemorrhagia [82.6 ％ (19/23) vs 85.7 ％ (24/28)].Difference on cardiac toxicity was statistically significant.Conclusions Compared with MEA regimen, FLAG regimen are similar effective and can be well tolerated,which has lower cardiac toxicity. Thus, FLAG regimen can be used as first-line treatment for relapsed and refractory adult acute myeloid leukemia.

Objective:To explore the relationships between perfectionism and coping strategies among graduate students.Methods:396 college graduate students completed the COPE (the Coping Inventory),FMPS (Frost's Multidimentional Perfectionism Scale) and General Self-efficacy Scale.Results:①Significant positive correlations were found between adaptive perfectionism and self-efficacy,while negative correlations between doubt about actions in maladaptive perfectionism and self-efficacy;② Regression analysis indicated predictability of perfectionism and self efficacy to coping strategies.Self-efficacy still had significant predictability after perfectionism and its sub-dimension were controlled.Conclusion:Self-efficacy plays an important mediation role between perfectionism and coping strategy.

ObjectiveTo observe the effect of exercise on expression of protein kinase B (PKB) in adipose tissue of insulin resistant rats fed by high fat diet.Methods30 male Wistar rats were randomly divided into the control group (n=10),given basic diet; the model group (n=20), given fat diet. After 4 weeks, the model group was randomly divided into 2 subgroups, the insulin resistant group was continually given high fat diet, the exercise treated group accepted high fat food and swimming training. After 6 week intervention, the expression of PKB stimulated by insulin in adipose tissue was determined with Western blotting at the end of experiment.ResultsAfter long term high fat diet, expression of PKB in adipose tissue of the insulin resistant group decreased by 23.5% comparing with the control group (P<0.01). After 6 weeks swimming training, the expression of PKB of the exercise treated group was increased by 19.2% comparing with the insulin resistant group (P<0.01).ConclusionExercise treatment can significantly elevate the expression of PKB and ameliorate the state of insulin resistance.

Objective:To study the influence of bone morphogenetic protein-7 ( BMP-7 ) on chondro-cyte secretion and expression of type Ⅱ collagen ( Col-Ⅱ) , aggrecan ( AGG ) and SRY-related high mobility group-box gene 9 ( Sox9 ) mRNA in porous tantalum-chondrocyte composites.Methods: The articular chondrocytes were isolated from 3-week-old New Zealand immature rabbits and identified.The 2nd generation of chondrocytes with 1 ×106/mL inoculate concentration was seeded in porous tantalum and divided into 4 groups, and control group ( tantalum/chondrocyte) , 50μg/L BMP-7 group (50μg/L BMP-7/tantalum/chondrocyte) , 100 μg/L BMP-7 group ( 100 μg/L BMP-7/tantalum/chondrocyte ) , and 200 μg/L BMP-7 group ( 200 μg/L BMP-7/tantalum/chondrocyte ) .The proliferation of chondro-cytes was measured by CCK-8 assay.The chondrocyte growth and morphology were observed by scanning electron microscopy ( SEM) .The synthesis of glycosaminoglycan ( GAG) in chondrocytes was tested by dimethyl methylene blue ( DMMB) colorimetric quantification method.Col-Ⅱ, AGG and Sox9 mRNA in chondrocytes were detected by real-time PCR.Results: The chondrocytes were spindle-shaped in 24 hours of primary cell culture and most cells became polygonal shaped in 4 days.The chondrocytes were affirmed by alcian blue, safranin O and Col-Ⅱimmunocytochemistry staining.The result of CCK-8 assay showed that the level of cell proliferation in 100 μg/L BMP-7 groups were higher than those in the other groups ( P<0 .05 ) .The chondrocytes implanted into porous tantalum scaffolds with BMP-7 had better functions, by which cytoplasmic processes developed and extended to the surface and inner of porous tan-talum by SEM observation.DMMB quantitative determination of GAG showed that GAG amount of chon-drocytes in 100 μg/L BMP-7 groups was significantly higher than those in the other groups ( P<0 .05 ) . The expressions of Col-Ⅱ, AGG and Sox9 mRNA in chondrocytes were up-regulated in the experimental groups, compared with the control group and the best effect appeared when concentration of BMP-7 was 200μg/L.(P<0.05).Conclusion:BMP-7/tantalum/chondrocytes composites enhanced in vitro chon-drocyte proliferation and extracellular matrix greatly, and can promote chondrogenic gene expression.

Healthy Beagle dogs were administrated with batroxobin by intravenous infusion at high, medium and low doses. The study of pharmacodynamics and pharmacokinetics was intended to clarify the relevance of them and provided strong evidence for clinical use of batroxobin. The blood samples were collected after injection based on the time schedule and samples were tested by ELISA method to get the concentration of batroxobin. At the same time, changes of prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT), fibrinogen (Fib) and D-dimmer were tested. The results showed that the concentration of D-D increased significantly after administration compared with that of before administration. The main pharmacokinetic parameters were as follows: t1/2 were (2.27 +/- 0.42) h, (10.65 +/- 2.19) h and (11.01 +/- 3.51) h; C(max) were (11.9 +/- 1.72) ng x mL(-1), (154.53 +/- 12.38) ng x mL(-1) and (172.14 +/- 47.33) ng x mL(-1); AUC(last) were (29.38 +/- 3.69) ng xh x mL(-1), (148.43 +/- 72.85) ng x h x mL(-1) and (599.22 +/- 359.61) ng x h x mL(-1). The elimination of batroxobin was found to be in accord with linear kinetics characteristics. The results of pharmacodynamics showed that D-dimmer level increased significantly after the administration of batroxobin, which was similar with the changes of batroxobin plasma concentration. Simultaneously, Fib concentrations in Beagle dog blood decreased significantly after the iv administration of batroxobin, while recovered to base level after 48 hours. PT, TT and APTT significantly became longer after administration, which returned to normal level after 48 hours. Especially, the D-dimmer levels and the batroxobin concentration in plasma after intravenous infusion of the drug were synchronized in Beagle dogs. Changes between PD/PK results had obvious correlation, and the D-dimmer levels in plasma can be one of the important monitoring indicators of batroxobin in thrombolytic medication.

A rapid, sensitive and simple liquid chromatography-tandem mass spectrometric (LC-MS/MS) method was developed for the simultaneous determination of yogliptin and its metabolite in Wistar rat plasma. Linagliptin and dexamethasone were chosen as the internal standards of yogliptin and its metabolite, (R)-8-(3-hydroxypiperidine- -yl)-7-(but-2-yn-1-yl)-1-((5-fluorobenzo[d]thiazol-2-yl)methyl)-3-methyl- H-purine-2, 6 (3H, 7H)-dione, respectively. After a simple protein precipitation using acetonitrile as the precipitating solvent, both analytes and ISs were separated on a Grace Altima HP C18 column (2.1 mm x 50 mm, 5 microm) with gradient elution using methanol (containing 0.1% formic acid, 4 mmol x L(-1) ammonium acetate)-0.1% formic acid (containing 4 mmol x L(-1) ammonium acetate) as the mobile phase. A chromatographic total run time of 4.4 min was achieved. Mass spectrometric detection was conducted with electrospray ionization under positive-ion and multiple-reaction monitoring modes. Linear calibration curves for yogliptin and its metabolite were over the concentration range of 0.5 to 500 ng x mL(-1) with a lower limit of quantification of 0.5 ng x mL(-1). The intra- and inter- assay precisions were all below 14%, the accuracies were all in standard ranges. The method was used to determine the concentration of yogliptin and M1 in Wistar rat plasma after a single oral administration of yogliptin (27 mg x kg(-1)). The method was proved to be selective, sensitive and suitable for pharmacokinetic study of yogliptin and M1 in Wistar rat plasma.

Objective To study the effect of flupentioxl melitracen and pinaverium bromide treatment on the changes of anorectal motility and rectal sensation in the patients of diarrhea-predominant irritable bowel syndrome (IBS-D) accompanying with depression and/or anxiety status. Methods Forty-four patients with IBS-D accompanying with depression and/or anxiety status were divided into group A (flupentioxl melitracen and pinaverium bromide) and group B (pinaverium bromide) by random digits table,and treated for 4 weeks. Twenty-five healthy subjects were included as control group. The anorectal motility and rectal sensation before and after taking medicines were compared. Results When abdominal pressure was increased, the net increased pressure of anal sphincter was (3.0 ± 1.2 ) kPa in group A and (2.9 ± 1.2)kPa in group B. They were lower than that in control group [(3.6 ± 1.6) kPa](P＜ 0.05). The rectal lowest volume of sensory threshold, the maximal volume of tolerance and maximal compliance were (55 ± 20) ml,( 145 ± 78 ) ml, ( 21.9 ± 12.9 ) ml/kPa in group A, ( 56 ± 38 ) ml, ( 150 ± 50 ) ml, (20.8 ± 11.2) ml/kPa in group B. They were lower than those in control group [(80 ± 38 ) ml, ( 190 ± 50 ) ml, (30.8 ± 15.2 ) ml/kPa](P ＜ 0.01 ). The rectal lowest volume of sensory threshold, the maximal volume of tolerance and maximal compliance were higher than those before taking medicines. Only the rectal lowest volume of sensory threshold in group B was higher than that before taking medicines. The rectal lowest volume of sensory threshold, the maximal volume of tolerance and maximal compliance in group A after taking medicines were higher than those in group B (P ＜ 0.05 or ＜ 0.01 ). Conclusions Higher sensitivity, lower tolerance,lower compliance of rectum and weakened anal automatic control function in IBS-D may be associated with diarrhea and frequent defecation. Treatment combining flupentioxl melitracen with pinaverium bromide may preferably improve the aperception functions of rectum in the patients of IBS-D accompanying with depression and/or anxiety status.