Objective To investigate the causes,treatments,and prevention of dysuria after transurethral resection of prostate (TURP). Methods The clinical data of 49 cases of dysuria post-TURP that were treated in our hospital from July 2004 to September 2008 were analyzed retrospectively. Results Among the cases,6 patients received silica catheterization again because of edema of the bladder neck and urethra; 9 underwent catheterization after bladder flush for delayed prostate bleeding; 20 underwent urethral dilatation or meatotomy due to meatal stenosis,5 received urethral dilatation for urethral stricture; urethral dilatation or direct vision internal urethrotomy were performed on 4 cases who had bladder neck fracture; TURP was carried out for a second time in 4 cases because of glandular residual; suprapubic cystostomy was made in 1 case of colonal carcinoma for long-term bed rest. All cases were cured after the treatment. Conclusions Meatal stenosis is the most common cause of dysuria post-TURP.Urethral dilatation is the first choice for the disease.

Objective To study the clinical significance of vires infection and serum interleukin-2 (IL-2)Ievels in recurrent childhood idiopathic thrombocytopenic purpura(ITP).Methods The cytomegalovirus(CMV),epstein-Barrvirus(EBV)-adenovirus(ADV),herpesvirus(HSV)antibodies ISM and IL-2 levels were determined in the serum of 4 childhood with recurrent childhood ITP as well as in 40 normal controls with ELISA and RIA.Re-sults The CMV-lgM positive cases were 18,EBV-IgM were 14-ADV-IgM were 5,HSV-lgM were 3.In the controls,those were 3,2,1,and 0 respectively(P<0.05 or P<0.01).The serum IL-2(0.35±0.12)μg/L levels were sig-nificantly lower than those in the controls[(0.61±0.17)μ/L,P<0.05].Conclusion DNA virus antibodies and IL-2 levels can reflect virus infection and immune condition of diseases in recurrent childhood ITP.It is impor-rant to comprehend the mechanism of recurrent childhood ITP for guiding clinical treatment.

Objective To investigate the effect of ultrasound-guided serratus plane block onefficacy of postoperative analgesia in patients undergoing radical mastectomy. Methods From January 2013 to December 2016, sixty-eight ASA physical statusⅠorⅡ patients scheduled for radical mastectomy under general anesthesia were randomly divided into two groups (n = 34 each): SP block group (observation group) and control group. After induction of anesthesia, ultrasound-guided homolateral SP block was performed, and 0.375% ropivacaine 20 ml was injected in observation group, while the equal volume of normal saline was used instead in control group. The patients received patient-controlled intravenous analgesia (PCIA) with sufentanil after operation in two groups. The scores of prince henry pain scale (PHPS) were evaluated at the 2nd, 4th, 8th, 12th and 24th hour (T1, T2, T3, T4, T5) after operation. The consumption of sufentanil, propofol and remifentanil was recorded.Meantime, the times of successfully delivered doses (D1) and attempts (D2) within 24 h after operation were added up, and D1/D2 was calculated. The adverse effects were also recorded. Results The scores of PHPS at T1 [(1.4 ± 0.5) scores vs. (3.1 ± 0.6) scores], T2 [(1.5 ± 0.6) scores vs. (2.9 ± 0.8) scores], T3 [(1.7 ± 0.5) scores vs. (2.8 ± 0.7) scores], and the consumption of sufentanil [(53.4 ± 16.7)μg vs. (87.8 ± 24.5)μg], remifentanil[(288.7 ± 42.1)μg vs. (376.5 ± 61.6)μg] were significantly lower in observation group than those in control group, while D1/D2 (0.89 ± 0.12 vs. 0.57 ± 0.18) was higher (P<0.05). The incidence of adverse reactions was significantly lower in observation group: 0 vs. 20.6% (7/34), P<0.05. Conclusions Ultrasound-guided SP block reduces the perioperative opioids consumption and enhances the efficacy of postoperative analgesia in patients undergoing radical mastectomy.

Objective To compare the clinical effectiveness and safety of transperitoneal robot assisted and retroperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty for the treatment of ureteropelvic junction obstruction. Methods From September 2008 to June 2009,six patients with primary UPJO underwent transperitoneal robot assisted dismembered pyeloplasty (TRADP) (5 males and 1 female;average age 25 yrs,range from 14-40 yrs),of whom 4 with severe hydronephrosis,2 with intermediate.According to the demographic and preoperative information,each patient in the TRADP group was matched to two corresponding patients with primary UPJO accepting retroperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty (RLADP) in the same period.The operative time,the intracorporeal suturing time,intraoperative blood loss,the duration of the urethral catheter and the drainage time,the postoperative hospital stay and the postoperative result were compared between the 2 groups.The two groups were identical with regard to gender,side of UPJO,and surgical procedure.The mean age and BMI were comparable between the TRADP and RLADP. Results Between the two groups,the operative time was ( 157 ± 20) min vs ( 127 ± 18) min ( P ＞ 0.05 ),the intracorporeal suturing time was (44 ± 6) min vs (49 ± 6 ) min ( P ＞0.05).In TRADP and RLADP groups,the intraoperative blood loss was (23 ± 8) ml vs (21 ± 17) ml ( P ＞ 0.05 ),the duration of the drain was (47 ± 10) h vs ( 161 ± 41 ) h ( P ＜ 0.01 ),the duration of the urethral catheter was (92 ±46) h vs ( 175 ±26) h (P ＜0.05),the postoperative hospital stays were (6.0 ± 0.8 ) d vs (8.0 ± 0.5) d ( P ＜ 0.01 ).The operation was successful in all cases of two groups,with no conversion to open surgery.The follow-up of 6 -32 months,with average of 20 months,showed that the clinical symptoms in the two groups disappeared and the hydronephrosis relieved. Conclusion Compared with RLADP,the TRADP has the comparable operative time,but the postoperative management for TRADP is more simple and the healing is faster,the postoperative outcomes are comparable as well.

Objective To study the influence of different concentration of Fructus Chebulae (Hezi)water solution on the quality of Aconiti Kusnezoffii Radix Praeparata (Zhicaowu),so as to optimize the process-ing technology and to find out the principle of detoxification of Hezi in processing.Methods Taking Hezi water solution with different concentration as the excipients,pH and content of total tannins were deter-mined.Then content of six alkaloids,indicator of toxic effect,in Zhicaowu were measured by reversed-phase HPLC.Results With the increasing of the concentration of Hezi water solution,the content of to-tal tannins increased,pH decreased at first,then kept stable,and the total six alkaloids increased slowly followed by irregularity.When the content ratio of Caowu to Hezi was 2∶1,consistent with Standard of Inner Mongolia Mongolian Medicines,the total alkaloids content was least.Conclusion Concentration of Hezi water solution and storage time changed the content of alkaloids in Zhicaowu.The content ratio of Hezi to Caowu recorded in Standard ofInner Mongolia Mongolian Medicines (in 1986)was scientific and valid.

Objective To develop a high-performance liquid chromatography(HPLC), and conduct an qualitative analysis of quality control ingredients of Radix Aconiti Kusnezoffii (Kusnezoff Monkshood Root, Caowu) processed with Fructus Chebulae (Medicine Terminalia Fruit, Hezi), and analyzed the effects of auxiliary materials and processing on the material basis of Aconiti Kusnezoffii Radix (Zhicaowu).Methods HPLC specific chromatogram was performed using Waters SunFire C18 column (250 mm×4.6 mm, 5 μm), gradient elution using formic acid in acetonitrile (A) and 10 mmol/L ammonium acetate solution (B) with flow rate at 1 mL/min, column temperature at 35℃ and injection volume of 10 μL;detection wave length with a UV detector at 254 nm for fingerprint analysis, 271 nm and 235 nm for the determination.Results HPLC specific diagram of caowu processed with hezi was established, and 28 communal peaks were confirmed including 17 from caowu and 11 from hezi.Two new peaks (peak 6 and peak 16) were identified as gallic acid and chebulagic acid based on reference.This HPLC specific analysis method also quantified gallic acid, chebulagic acid, benzoylmesaconine and mesaconitine.Conclusion This specific HPLC method is easy to perform and also reliable.It could quickly identify raw, processed, and hezi-processed caowu, and distinguish different ingredients of caowu and its processed products.

Objective To investigate certified specialized nurses' willingness in building an reappraisal system and to provide a basis for further completing the appraisal system and criteria for specialized nurses, defining their roles, and encouraging them to play their leading roles in clinical work.Methods Totally 250 certified specialized nurses from 8 Class Ⅲ hospitals in Beijing were selected by convenient sampling and investigated with the self-designed questionnaire. The subjects' willingness in building the reappraisal system and criteria were analyzed.Results In terms of the 240 specialized nurses' wiliness in building the reappraisal system, their scores in clinical competence, teaching ability and research capability were (13.14±3.86), (13.60±2.27) and (9.50±2.94), respectively. There was statistical difference in the willingness in building the evaluation criteria of clinical competence between specialized nurses with different length of service and titles (P<0.05); there was also statistical difference in the willingness in building the evaluation criteria of teaching ability between specialized nurses with different educational background (P<0.05).Conclusions The specialized nurses' willingness in building the reappraisal indicators. Nursing managers shall train specialized nurses based on their shortcomings, build stricter criteria for future training for specialized nurses, and encourage the nursing team to become expert nurses.

Objective:To assess the efficacy and safety of 100 units of botulinum toxin A (BTX-A) intradetrusor injection in patients with overactive bladder.Methods:From April 2016 to December 2018, 17 tertiary hospitals were selected to participate in this prospective, multicenter, randomized, double-blind, placebo-controlled study. Two phases of study were conducted: the primary phase and the extended phase. This study enrolled patients aged 18 to 75 years who had been inadequately managed by anticholinergic therapy (insufficient efficacy or intolerable side effects) and had spontaneous voiding with overactive bladder. Exclusion criteria included patients with severe cardiac, renal and hepatic disorders, patients with previous botulinum toxin treatment for 6 months or allergic to BTX-A, patients with urinary tract infections, patients with urinary stones, urinary tract tumors, diabetes mellitus, and bleeding tendency. Eligible patients were randomly assigned to BTX-A group and placebo control group in a ratio of 2∶1. Two groups of patients received 20 intradetrusor injections of BTX-A 100U or placebo at the depth of the submucosal muscle layer respectively under cystoscope, including 5 injections at the base of the bladder, 3 injections to the bladder triangle, 5 injections each to the left and right walls and 2 injections to the top, sparing the bladder neck. As a placebo control group, patients received same volume of placebo containing no BTX-A and only adjuvant freeze-dried preparations for injection with the same method. A combination of gelatin, sucrose, and dextran served as adjuvants. Average micturition times per 24 hours, urinary incontinence (UI) episodes per day, average micturition volume per day, OAB symptom score(OABSS), and quality of life (QOL) score were recorded at baseline and the 2nd, 6th and 12th week after treatment. The primary efficacy endpoint was the change from baseline in the average micturition times per 24 hours at the 6th week after treatment. The secondary efficacy endpoints included the change from baseline in the average micturition times per 24 hours at 2nd and 12th week, as well as the change from baseline in the OABSS, QOL score, average frequency of urgency and UI episodes per day, urgency score, average micturition volume per day at 2nd, 6th and 12th week after treatment. Patients were followed for 12 weeks to assess adverse events (AEs). After assessed at week 12, if the micturition times has decreased less than 50% compared to baseline and the patient is willing to receive retreatment, then patients could enter the extended trial phase. In that phase, patients in both groups were injected with 100 units BTX-A from 12th week onwards and then followed up the same indicators for 12 weeks.Results:216 patients were enrolled in this trial (144 cases in the BTX-A group and 72 cases in the placebo control group). Baseline characteristics such as age (47.75±14.20 in the BTX-A group and 46.39±15.55 in the control group), sex (25 male/117 female in the BTX-A group and 10/61 in the control group), and disease duration (0.51 years in the BTX-A group and 0.60 years in the control group) were balanced between the two groups( P>0.05). A marked reduction from baseline in average micturition times per 24 hours was observed in all treatment groups at the 6th week and the reduction of the two groups was statistically different ( P<0.001 and P=0.008 respectively). Compared with the baseline, the average micturition times per 24 hours at the 6th week decreased from baseline by 2.40(0.70, 4.60)times for the BTX-A group and 0.70(-1.00, 3.30) times for the placebo control group respectively, and the difference between the two groups was considered to be statistically significant ( P=0.003). The change rates of average micturition times per 24 hours from baseline at the 6th week of the two groups were (16±22)% and (8±25)% respectively, and the difference between the two groups was statistically significant ( P=0.014). Compared with the baseline, the average micturition times per 24 hours at 2nd and 12th week decreased by 2.00(0.00, 4.00)and 3.30(0.60, 5.03)for the BTX-A group, 1.00(-1.00, 3.00)and 1.70(-1.45, 3.85)for the placebo control group respectively. The difference between two groups was considered to be statistically significant ( P=0.038 and P=0.012); the changes of average urgency times per day for the BTX-A group and the control group at the 2nd, 6th and 12th week were 2.00(0.00, 4.30)and 2.40(0.30, 5.00), 3.00(0.30, 5.70)and 0.70(-1.30, 2.70), 0.70(-1.30, 3.00) and 1.35(-1.15, 3.50), respectively. There were significant differences between two groups at the 2nd, 6th and 12th week, ( P=0.010, P=0.003 and P=0.025, respectively). The OABSS of the BTX-A group and the control group at the 6th week decreased by 1.00(0.00, 4.00)and 0.50(-1.00, 2.00) compared with the baseline, and the difference between the two groups was statistically significant ( P=0.003). 47 cases of BTX-A group and 34 cases of placebo control group entered the extended trial phase, and 40 and 28 cases completed the extended trial phase, respectively. The average micturition volume per 24 hours changed by -16.60(-41.60, -0.60)ml and -6.40(-22.40, 13.30)ml, (-35.67±54.41)ml and(-1.76±48.69)ml, (-36.14±41.51)ml and (-9.28±44.59)ml, (-35.85±43.35)ml and(-10.41±40.29)ml for two groups at the 12th, 14th, 18th and 24th week, and the difference between two groups was statistically significant at each follow-up time ( P=0.01, 0.006, 0.012 and 0.016, respectively). There was no significant difference in other parameters( P>0.05). However, adverse reactions after intradetrusor injection included increased residual urine volume (27 in the BTX-A group and 3 in the control group), dysuria (21 in the BTX-A group and 6 in the control group), urinary infection (19 in the BTX-A group and 6 in the control group), bladder neck obstruction (3 in the BTX-A group and 0 in the control group), hematuria (3 in the BTX-A group and 1 in the control group), elevated alanine aminotransferase (3 in the BTX-A group and 0 in the control group), etc. During the follow-up period, there was no significant difference in the other adverse events between two groups except the increase of residual urine volume( P<0.05). In the primary trial phase, among the 27 cases with increased residual urine volume in BTA group, only 1 case (3.70%) with PVR more than 300 ml; the PVR of 3 patients in the placebo group was less than 100 ml. The increase of residual urine volume caused by the injection could be improved or disappeared with the passage of time. Conclusions:Intradetrusor injection of Chinese BTX-A improved the average micturition times per 24 hours, the average daily urgent micturition times, OABSS, and average micturition volume per time, and reduced the adverse effects in patients with overactive bladder.Chinese BTX-A at dose of 100U demonstrated durable efficacy and safety in the management of overactive bladder.