Objective To evaluate the clinical features and renal morphological changes of the patients with urinary tract infection associated ureteral stent.Methods From Oct.2012 to May.2013,21 patients were divided into three groups depending on the different conditions:Group A (n=7):patients who had febrile urinary tract infections associated with ureteral stents; Group B (n =7):patients with ureteral stents but no fever; Group C (n=7):patients who had febrile urinary tract infections but no ureteral stent.The clinical data,laboratory data and 99Tcm-dimercaptosuccinic acid (DMSA) renal scintigraphy results were recorded prospectively and analyzed.Results In Group A,there were two patients had flank pain and positive costovertebral angle percussion tcnderness.The mean value of white blood cells and Hs-CRP of Group A and Group C were obviously higher than Group B (P＜0.05).The ratios of pyuria were 100.0％,71.4％ and 100.0％ in Group A,B and C.The ratios of positive urine bacteuria culture were 100.0％,42.9％ and 100.0％ in Group A,B and C.The results of 99Tcm-DMSA renal scintigraphy demonstrated the decreased uptake in the different portion of the kidneys on the sides of ureteral stents inserted in all the patients in Group A but no such changes in Group B and Group C.Conclusions 99Tcm-DMSA renal scintigraphy can be used to judge the status of urinary tract infection associated ureteral stent.The febrile urinary tract infection associated with ureteral stents always means pyelonephritis occurs and prompt treatment must be given.

Objective To observe the incidence and transformation of pyuria and bacteriuria in different time point after TURP and supply the evidence for antibiotic application.Methods From March,2011 to May,2012,84 patients with BPH admitted in our hospital.Their ages ranged from 61 to 87 years old,mean (71.9±7.6) years.The volume of prostate in those patients ranged from 27.8 to 118 ml,mean (70.8±24.1) ml.The procedure of TURP was undergone in all of them.In one week after the operation,two urine specimens from each patient,one for urine routine examination and one for urine culture,were collected 24 h after the catheter have been withdrawn.The catheter was also cultured.During the following-up,urine routine examination and urine culture were regularly performed in 1,2,3 months after surgery.If the patient had both pyuria and bacteriuria,he should be excluded the study.Results The pyuria rate on one week,one month,two months and three months were 54.8％ (46/84),100.0％ (82/82),65.8％ (48/ 73),34.2％ (25/73),respectively.There is a significance difference among those groups (P＜0.05).It seemed that the pyuria would appear in all patients.However,the incidence would gradually decrease.It seemed that the pyuria has the tendency of self-recovery.A significant difference of prostatic resection volume after 3 months could be observed in the pyuria group (31.4±15.2 ml) and non-pyuria group (24.8±11.6 ml) (P＜0.05).The bacteriuria rate on one week,1,2,3 months were 7.1％ (6/84),11.0％ (9/82),6.8％ (5/73)and 0,respectively.There is no significance difference among the groups (P＞0.05).Conclusions Pyuria will appear after TURP and the incidence reduced gradually following the time.The pyuria alone without the bacteriuria may be explained by inflammation,that antibiotics were unnecessary.The bacteriuria alone without the pyuria may be considered as asymptomatic bacteriuria or bacterial colonization,antibiotics were unnecessary,either.

Objective To explore the expression of FOXM1 in non-small cell lung cancer(NSCLC) and the relationship between FOXM1 expression and the clinical pathological factors,clinical response to target-therapy in NSCLC remained unknown.Methods A total of 80 NSCLC patients were recruited into this study,FOXM1 expression was assessed by immunohistochemistry and analyzed with the clinical pathological factors and clinical response to target-therapy.Results The positive rate of FOXM1 expression was 41.25%.The positive expression of FOXM1 had no significant difference in patients with different age,gender,cancer staging,smoking history(P>0.05),but had significant difference in patients with different degree of differentiation,lymph node metastasis(P<0.05).Survival time in patients with positive FOXM1 expression was significant shorter than that with negative FOXM1 expression(P<0.05).Conclusion The expression of FOXM1 closely correlated with patients histological differentiation,lymph node metastasis,progress-free survival time in patients with positive FOXM1 expression was significantly shorter than those with negative FOXM1 expression.

BACKGROUND: Apoptosis of cardiomyocytes is speeded up during ischemic reperfused injury. Acupuncture on the points of hand- Jueyin meridian can inhibit the progression of reperfused injury and reduce apoptosis of cardiomyocytes so as to provide the protection on the heart.OBJECTIVE: To observe the effects of acupuncture on the points of hand-Jueyin meridian on apoptosis of cardiomyocytes during ischemic reperfused injury.DESIGN: Randomized controlled experiment based on the experimental animals.SETTING: Department of acupuncture and massage in a university of traditional Chinese medicine.MATERIALS: The experiment was performed in Central Laboratory of Shandong University of Traditional Chinese Medicine from April to December 2001. Forty Wistar male rats were employed, and were randomized into 5 groups, named as blank group, model group, "Neiguan(PC 6)" group,"Ximen(PC 4)" group and "Zhigou(TE 6)" group.METHODS: After electric acupuncture on the points of pericardium meridian for 20 minutes, the ligature was done on the anterior-descending branch of the left coronary artery for 40 minutes. Electrocardiogram (ECG) monitoring was followed. The ligature was released after electric acupuncture on the points for another 20 minutes and perfusion was restored for 60 minutes. Afterward, the heart was extracted, the cellular suspension was prepared and the determination with flow-type cell apparatus was applied.MAIN OUTCOME MEASURES: Effects of acupuncture on the changes in apoptosis rate of cardiomyocytes.RESULTS: In the model group, the typical apoptosis peak presented, the apoptosis rate was remarkably increased. The comparison between the points of pericardium meridian groups and the model group indicated very significant difference(P < 0.01) .The apoptosis rates in "Neiguan(PC 6)" group, "Ximen(PC 4)" group and "Zhigou(TE 6)" group as well as the model groupwere(4.29±0.76)%, (5. 17±0.88)%, (13.96 ±2.77)% and (16.01 ± 1.04)% respectively.CONCLUSION: Acupuncture on the points of hand-Jueyin meridian inhibits myocardial apoptosis effectively so as to reduce myocardial injury caused by cell apoptosis.

Objective To investigate the cause of low rate for dementia diagnosiss in out-patient clinic.Methods All outpatients between September 15,2009 and December 25,2009 were screened by IQCODE,MMSE and neuropsychological examination.Diagnosis of dementia and its subtype were confirmed according to DSM-IV-TR,NINCDS-ADRDA,and NINDS-AIREN criteria.The caregivers of dementia patients were interviewed with questionnaire.Results There were 8,042 outpatients in the period and 1716 patients completed IQCODE,317 completed MMSE,72 completed a set of neuropsychological test.41 patients were diagnosed as dementia which composed of 23 cases of AD (56.1％),12 cases of vascular dementia(29.3％),2 cases of mixed dementia(4.9％),4 cases of other types of dementia(9.7％),and the prevalence of dementia at age of over 55 years was 1.8％ in out-patient clinics.Among the patients,18 cases were mild dementia (43.9％),19 moderate dementia (46.3 ％ ) and 4 severe dementia (9.8 ％).Four patients(9.8 ％ ) were diagnosed as dementia by case history,15 patients(36.5％) were diagnosed as dementia by clinic doctors,while 22 patients (53.7％) were diagnosed as dementia in the survey.35 caregivers finished questionaire,and 10 caregivers(28.6％) had no knowledge about dementia,22(62.8％) caregivers had a few knowledge and 3(8.6％) caregivers had lots of knowledge.19 (46.3％) dementia patients went to see a doctor with cognitive impairment and 22 (53.7 ％) with other symptoms.The reasons for delay in seeing a doctor included that caregivers considered the impairment of cognition as a result of normal aging (54.3％),patients rejected to see a doctor(14.3％),caregivers considered no treatment for dementia (5.7 ％),and there was economic reason ( 2.9％),inconvenient (8.5 ％) and others ( 14.3 ％).Conclusions The visiting rate of dementia patients in china is very low and many demented patients do not receive early diagnosis and treatment.Patients' delay may contribute to the lack of knowledge of caregivers,and to doctor's ignore of the cognitive impairment.

Objective To introduce the surgery procedure of pin-shaped bipolar plasmakinetic transurethral en bloc resection of non muscle-invasive bladder urothelial carcinoma and investigate the clinical outcomes.Methods 42 cases of non muscle-invasive bladder urothelial carcinoma who received bipolar plasmakinetic transurethral en bloc resection from May 2015 to March 2016 were recruited in the present study.Male 29 cases, female 13 cases, average age 52-82 years old, average (65.6 ±12.3) years old.Wide basal tumors were noticed by preoperative cystoscopy, bladder tumors were confirmed by tumor biopsy.Full-thickness specimens were obtained in procedures, including tumor, mucosa, lamina propria layer, muscular layer, to accurately assess tumor infiltration depth and staging.Results All 42 cases were done by this procedure successfully.A total of 65 pieces of tumors were excised:36 in lateral wall, 19 in posterior wall, 10 in bladder triangle.Tumor diameter ranged from 0.5 to 3.5 cm, with an average (2.1 ± 0.6) cm.Postoperative pathological stages were clear:16 cases were Ta stage and 49 cases were T1 stage ( of which 32 were T1 G3 ) .Intraoperative obturator nerve reflex happened in 2 cases.Followed up for 2-11 months, average 6 months.Tumor recurrence in 3 cases, no progression case.Conclusions Pin-shaped bipolar plasmakinetic electrode transurethral en bloc resection of non muscle-invasive bladder urothelial carcinoma is safe and reliable and should be recommended in management of non muscle-invasive bladder urothelial carcinoma.Full-thickness postoperative specimens can provide accurately judgement of the depth of tumor invasion and pathological staging.

Objective To study the relationship between the bladder outlet obstruction(BOO)and the area under the curve of detrusor during voiding related parameters. Methods One hundred and thirty-eight patiens with benign prostate hyperplasia(BPH) underwent clinical evaluation, including physical examination, flow rate and post-void residual volume measurement. Pressure flow studies were performed. Mean patient age was 68 years (range 56 to 82). The AG number and the LinPURR were recorded to classify the patients into 3 groups, namely unobstructed, equivocal obstructed and obstructed, as the traditional classification. Two new parameters including the area under the curve of detrusor pressure during voiding(AUCdet) and the area under the curve of detrusor pressure during voiding adjusted for voided volume(AUCdet/Vol) were calculated and compared with the traditional classification using the Linear discriminant analysis. Results According to the traditional classification, there were 33 unobstructed, 32 equivocal and 44 obstructed cases. The AUCdet and AUCder/Vol of the 3 groups were different(P＜0.001). Linear discriminant analysis showed that of the cases, 90. 9%(30/33), 43.8%(14/32) and 70. 5%(31/44) were identically categorized by the traditional and the AUCdet/Vol classifications in the unobstructed, equivocal and obstructed groups, respectively. Conclusions The area under the curve of detrusor pressure during voiding related parameters appear to be good parameters of the BOO in patients with BPH. Further studies are needed to test the reliability and validity of these new parameters.

Objective To study the change of clinical and urodynamic parameters in the patients with lower urinary tract symptom (LUTS) caused by detrusor overactivity (DO). Methods Two hundred and twenty-seven patients with LUTS underwent clinical evaluation from October 2006 to December 2008, including Prostate Volume (PV), International Prostate Symptom Score (IPSS), Peak Flow rate (PF) and Residual Urine (RU) measurement. Pressure flow studies were performed. The detrusor overactivity was recorded to classify the patients into 2 groups, DO group and none DO group. The clinical and urodynamic parameters were compared between the two groups. Results Mean patient age was 70 years (range 52 to 89). According to the urodynamic results, there were 126 patients in DO group and 101 patients in none DO group. The mean patients age was older in DO group than the none DO group(P＜0.05). Adjusted by age, the PV, PF, and RU were no different between the two groups(P>0.05). The mean first sensation of bladder, bladder compliance, cystometric capacity, bladder outlet obstruction parameters, single voiding volume and max detrusor pressure during contraction were different between the two groups(P＜0.05). Conclusions The main risk factors of DO are the ageing and BOO. The non invasive parameters such as PV、 PF、 and RU could not be used to judge DO. The changes of urodynamic parameters caused by DO were hyperaesthesia of bladder、lower bladder compliance、 higher max detrusor pressure and lower max cystometric capacity. This study emphasis the importance of the urodynamic studies in the aged patients with LUTS.

Objectives To study the clinical diagnostic value of soluble major histocompatibility complex class Ⅰ-related chain A(sMICA) and analyse the relationship of tumor biologic characteristics and sMICA in lung cancer. Methods The experimental level of sMICA was determined by ELISA in 116 lung cancer patients. The level of serum CEA, NSE, CA-199, CYFRA-211, SCC, ProGRP were determined by ELISA only in 91 lung cancer patients without any therapy. The level of sMICA in 50 normal persons was regarded as control group. Results The level of sMICA in lung cancer patients was significantly higher than that in control group (P<0.001); When sMICA cut-off was set as 240.5 ng/L, the sensitivity for the detection of lung cancer was 90.1%, the speciality was 46.9%. The positive rate of sMICA was significantly higher than that of CEA, NSE, CA-199, CYFRA-211, SCC, ProGRP(P<0.001 respectively); The level of sMICA in lung cancer patients with CR and PR after treatment were lower than that before treatment(P<0.05). The level of sMICA in lung cancer patients with relapse was higher than patients without any treatment (P<0.001). Conclusion SMICA may be a potential marker for diagnosing lung cancer with high sensitivity and speciality. It is associated with tumor progression and distant metastasis and may be helpful in the evaluation of diagnosis for lung cancer.

Objective To learn the current anesthesiologists deployment at the hospital,and to figure out how to measure anesthesiologists deployment.Methods Existing data and expert consultation were used to obtain various indicators,and the current anesthesiologists deployment was analyzed,calculating with the formula the needed number of anesthesiologists.Results Despite the rising demand and resource utilization,anesthesiologists were found in obvious shortage at the hospital.The number of anesthesiologists needed was calculated as 101.4,with a vacancy of 11.4.Conclusion The national health authorities were recommended to revise the standard of anesthesiologists deployment at hospitals.