Objective:To explore the effect of improved urethral irrigation on urethral stricture in patients with closed bulbar urethral injury.Methods:The clinical data of 65 male patients with closed bulbar urethral injury complicated with difficult catheterization from January 2014 to January 2018 in the First Hospital of Shanxi Medical University were retrospectively analyzed. Among them, 30 cases were treated with flexible cystoscope-guided catheterization and external urethral orifice nursing (routine group), and 35 cases were treated with flexible cystoscope-guided catheterization and urethral drug flushing (improved group). The incidence of urethral stricture 1 and 6 months after catheter removal, number of urethral dilatation and maximum urinary flow rate 6 months after catheter removal, visual analogue score (VAS) during indwelling catheter were compared between 2 groups.Results:Both groups indwelled the catheters successfully. During indwelling catheter, the inflammatory secretion in improved group was less and thinner than that in routine group. There was no significant difference in the incidence of urethral stricture 1 month after catheter removal and VAS during indwelling catheter between 2 groups ( P>0.05); the incidence of urethral stricture and number of urethral dilatation 6 months after catheter removal in improved group were significantly lower than those in routine group: 5.7% (2/35) vs. 26.7% (8/30) and (7.1±1.0) times vs. (11.4±1.8) times, the maximum urinary flow rate 6 months after catheter removal was significantly higher than that in routine group: (19.8 ± 2.9) ml/s vs. (16.3±2.3) ml/s, and there were statistical differences ( P<0.05 or <0.01). Conclusions:The system of improved urethral irrigation can be easily fabricated and can achieve convenient application. This improved treatment can facilitate the discharge of urethral secretions, alleviate the urethral inflammation, reduce the urethral scar formation, and can prevent the incidence of bulbar urethral stricture effectively.

Objective To explore the effect of vibration sputum elimination apparatus combined with atomization treat-ment of patients with acute exacerbation of chronic obstructive pulmonary disease. Methods A retrospective analysis was performed on 60 cases of acute exacerbation of chronic obstructive pulmonary disease patients clinical data in our hospital from January 2014 to January 2015. Results 7 days after treatment, the clinical symptom score of the observa-tion group were significantly lower than that in the control group (P<0.05), the normal blood and sputum time to reduce the amount of time of the observation group were significantly shorter than that in control group, pH, PaO2 was signifi-cantly higher than that in the control group, PaCO2 was significantly lower than that in the control group after the treat-ment(P<0.05). Conclusion It can get good effects of treat the patients with acute exacerbation of chronic obstructive pulmonary disease with vibration sputum elimination apparatus combined with atomization .

Objective To evaluate the effect of non-invasive ventilator combined with compound ipratropium bromide inhalation in the acute exacerbation of chronic obstructive pulmonary disease. Methods 60 patients with acute exacerbation of chronic obstructive pulmonary disease were included in this study. Data were collected from March 2013 to March 2017. Participants were randomly and equally divided into observational group and control group. The control group was given routine treatment such as relieving cough and reducing sputum, anti-infection, etc. On the basis of control group, the observation group was given combined with non-invasive ventilator combined with compound ipratropium bromide inhalation therapy. The hospitalization time, APACHE Ⅱ score, tracheal intubation status of the two groups were compared and analyzed. Results The results showed that after different treatments there were 8 cases of tracheal intubation in the control group and 3 cases in the observation group, and the tracheal intubation rate was statistically different(P＜0. 05). In addition, there was no significant difference in partial pressure of oxygen, partial pressure of carbon dioxide and APACHE Ⅱ score between the two groups before treatment, while the difference was significant after treatment, and the length of hospitalization was also statistically significant (P＜0. 05). Conclusion In the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease, a non-invasive ventilator combined with compound ipratropium bromide on the basis of routine treatment can effectively shorten the hospital stay, improve the patient's oxygen partial pressure, and the overall treatment effect is significant, which deserve promotion.

Objective To study urodynamic changes of urine at different degrees of hydronephrosis based on computational fluid dynamics (CFD) method, so as evaluate the influence of hydronephrosis degree on kidneys’ ability to discharge stones. Methods Twelve models, including the branched pelvis Model A (normal hydronephrosis A1, mild hydronephrosis A2, medium hydronephrosis A3, severe hydronephrosis A4 models), mature ampullary pelvis Model B (normal hydronephrosis B1, mild hydronephrosis B2, medium hydronephrosis B3, severe hydronephrosis B4 models), and embryo pot abdominal pelvis Model C (normal hydronephrosis C1, mild hydronephrosis C2, medium hydronephrosis C3, severe hydronephrosis C4 models) were established. The urine flow velocity and velocity vector at the neck of the kidney, the outlet of the renal pelvis were calculated by CFD method. Results As the degree of hydronephrosis increased, the flow velocity of urine at the neck of the kidney and the outlet of the renal pelvis decreased. The urinary shearing force of the stones and the kidney’s ability to discharge stones gradually decreased, whereas the circulatory stagnation zone and the velocity boundary layer in kidney aggregate system gradually increased. Conclusions Hydronephrosis can cause changes in urodynamics of the urine. Therefore, the effect of hydronephrosis with different degrees on the patient’s ability to discharge stones after surgery should be fully considered， so as to choose an appropriate treatment method for kidney stones in clinic.

【Objective】 To clarify the role and molecular mechanism of Tanshinone ⅡA (TanⅡA) in the pathological integration of granule cells in the dentate gyrus (DG) by using the mouse model of temporal lobe epilepsy (TLE). 【Methods】 Status epilepticus (SE) was induced in the mice with pilocarpine and treated with TanⅡA 5 mg/kg. After two months, Morris water maze was used to examine the spatial learning and memory ability and video surveillance was used to monitor spontaneous seizures. The DG was removed for staining of Timm, Prox-1, DCX and SynⅠ. PTEN, p-AKT, and p-S6 expressions were observed by Western blotting. 【Results】 TanⅡA decreased Timm score, SynⅠ, PSD-95 and pS6 levels, and increased the level of PTEN in the DG, and attenuated the formation of mossy fiber sproutings and basal dendrites of the granule cells. Video surveillance showed that TanⅡA reduced the frequency of Racine’ grade 5 seizures. 【Conclusion】 TanⅡA can effectively attenuate the abnormal integration of the granule cells in the DG by regulating PTEN/AKT/mTOR pathway and thus plays an anti-epileptic role.