Objective To evaluate the therapeutic effect of extra-fine choledochoscope in treating polypoid lesions of gallbladder by percutaneous trans-hepatic and trans-gallbladder puncture(PTGB). Methods Extra-fine choledochoscope(2. 7 mm diameter)was inserted into tract soon after it was made per-cutaneously trans-hepatic and dilated in one session,gallbladder polyps was removed with biopsy forceps or snare or basket,and PTCD drainage tube(10. 2 F diameter)was imbedded for external drainage until 10 days after. If the gallbladder puncture point fell on the bed and gallbladder polyps were not clearly visual-ized,or puncture points were on non-gallbladder bed of the body,drainage tube(10. 2 F diameter)was placed for external drainage. Results Forty-two patients were successfully punctured,and 40 patients were punctured accurately on the bed in,and the fresh endoscope tract of these patients was established in 45 mi-nutes on average. Of the 29 cases of simple bottom and body ventral polyps,complete clearance of gallbladder polyps was achieved in 27. Gallbladder polyps clearance rate was 93. 10%. Complications of minor hemobi-lia occurred in 9 cases,and infection of biliary tract occurred in 3 cases after operation. There was no recur-rence after a follow-up of 15 months on average. Conclusion Extra-fine choledochoscope by PTGB is a less invasive,more reliable and effective method to cure benign polypoid lesions of the gallbladder. The gallblad-der is preserved and for malignant polyps,it can help to achieve early diagnosis and provide reliable evidence for further treatment.

Urinary tract infection (UTI) is one of the most common infectious diseases. It has the characteristics of high recurrence rate and prolonged course. At present, the problem of antibiotic resistance is becoming more and more serious, the incidence of adverse reactions is high, and the disadvantages of long-term administration appear, which brings severe challenges to the treatment of recurrent urinary tract infection. The prevention and treatment of UTI recurrence has become the focus of research. Recurrent urinary tract infection is related to the immune regulation mechanism of the body. Administration of immune regulation can provide new ideas for prevention and treatment. The vaccine based on immune regulation to prevent rUTI has made some progress. It can not only reduce the frequency of recurrences, but also decrease related symptoms. At the same time, the vaccine has good tolerance, high safety and good application prospect. This paper aims to summarize the progress of immune regulation and immune vaccines in vivo and clinical research.