This paper reports nursing of 11 patients undergoing laparoscopic radical cystectomy with orthotopic ileal neobladder. The nursing points included preoperative bowel care,psychological care,observation of drainage tubes and complications,guidance of pelvic floor muscle training and bladder training with timed voiding. Patients receiving bladder training after catheter removal,and got self-control urination in 2 weeks. Only a patient left urinary incontinence at night occasionally.

Objective To establish the determination of Dehydroandrographolide in Ganmaoqing Capsule. MethodsThe determination was carried out by HPLC with a KromasilC-18 column(250 mm ×4.6 mm,5μm),methanol-water(65:35)severed as the mobile phase,the speed was 1mL/min and the detection wavelength was at 254 nm. ResultsDehydroandrographolide showed a good linear relationship at the range of 0.04872 μg ～0.38976 μg(r2 =0.9995,n= 8);The average recovery of Dehydroandrographolide was 100.1%(RSD= 2.92%). ConclusionHPLC method was sensitive,accurate,reproducible,specific and could be used for quality control of Ganmaoqing Capsule efficiently.

TIMI Flow as a method to assess myocardial reperfusion has been employed clinically ever since 1980's.TIMI Frame Count grading is a more objective,repeatable and correlative in variablity than those of TIMI Flow.TMBG and TMP provide the reperfusion evaluation on myocardial microvascular level.Doppler contrast echocardiography could be used as an additional index to assess vessel recanalization and myocardial reperfusion.Moreover,MCE,continuous ECG monitoring of ST-segment,isotope imaging of myocardial reperfusion and myocardial-enhanced MRI can all be used as non-invasive evaluating approaches with great clinical value.(J Intervent Radiol,2006,15:250-253)

Cataract and age-related macular degeneration (AMD) often present concurrently in aged persons. There has been a longstanding controversy among clinicians as to whether cataract surgery is contraindicated in eyes with AMD. Most of previous researches indicated that cataract surgery could accelerate the progression of AMD. However recently studies suggested that cataract surgery improved visual function of the patients and didn't accelerate the progression of AMD. These are related to the development of cataract surgery and the using of phacoemulsification technique.

Next-generation sequencing (NGS) platforms have recently evolved to provide an accurate and comprehensive means for the detection of molecular mutations in acute myeloid leukemia(AML).The 54th ASH annal meeting reported lots of studies on NGS in AML,reflect the important role of the NGS technology in modern diagnosis and treatment of blood diseases and the impact on the future development of the blood disease.

Objectvi e To investigate whether promoting gap junctions may contribute to the radiosensi-tivity in triple negative breast cancer( TNBC)cells.Methods HCC70(triple-negative),MCF-7(ER-posi-tive)or SK-BR3(HER2-positive )cells were transfected with pcDNA/5 -Cx43 expression plasmid using liposome 2000.The transfected cells were treated with various doses of radiation(0,5,10,15 Gy),and the level of Cx43 protein was determined by Western blot and the cell connectivity was determined by fluorescent tracer technique. Cell proliferation inhibition,clone formation ability and apoptosis were detected using MTT,clone formation assay, AnnexinV-FITC/PI double staining and flow cytometer,respectively.Results The level of Cx43 protein signifi-cantly increased in HCC 70 -Cx43 ,MCF-7 -Cx43 and SK-BR3 -Cx43 cells.After transfection the cells were treated with various doses of radiation,level of Cx43protein was gradually enhanced in dose dependent fashion .The re-sults form fluorescent tracer technique showed that fluorescence intensity was gradually elevated with increase of radiation doses.Cell viability and clone formation ability were decreased gradually in dose dependent manner in HCC70-Cx43 ,MCF-7 -Cx43 and SK-BR3-Cx 43 cells.Unexpectedly,the inhibitive effect of proliferation ability and clone formation ability in HCC70 -Cx43 cell was higher than in MCF-7 -Cx43 and SK-BR3 -Cx43 cells under same conditions.The results from AnnexinV-FITC/PI and flow cytometer showed that apoptosis rate was enhanced gradually accompanying with increase of radiation doses.Conclu sion Enhancing the function of cell gap junc-tions promoted radiosensitivity of breast cancer cells,particularly in TNBC cells.Radiation can strengthen cell gap junctions in breast cancer cell and cytotoxicity of TNBC cell can be enhanced by both synergistic effects.

Objective To evaluate the efficacy of intravitreal injections of conbercept in choroidal neovascularization (CNV) secondary to pathologic myopia (PM).Methods A retrospective case series of 37 eyes of 37 patients affected with CNV secondary to PM treated by intravitreal injections of Conbercept.All the patients were examined with best-corrected visual acuity (BCVA) of Early Treatment Diabetic Retinopathy Study (ETDRS) chart,central macular thickness (CMT) of optical coherence tomography (OCT) at baseline.The initial average letters of ETDRS BCVA was 49.86±8.87,CMT was (306.38±31.01) μm.All eyes were treated with intravitreal Conbercept 0.05 ml (10 mg/ml).Follow up visits were performed monthly after injection.The mean follow-up time was 16.8 months.Injections were repeated according to the situation of BCVA,CMT,subretinal fluid and CNV leakage in follow-up.All eyes received an average of 4.8 injections.BCVA,CMT and ophthalmoscope examination were assessed monthly.The relationship of BCVA improvement and CMT reduction with the data at baseline and number of treatments were analyzed by Spearman Rho correlation respectively.Results During the 1,3,6 and 12 months after treatment,the mean BCVA were all improved with statistically significant difference (t=17.629,P＜0.01).At 12 months,15 eyes (45.9％) had improvement of 15 letters or more,32 eyes (86.5％) had improvement of 5 letters or more,and 1 eye (2.7％) had decreased more than 5 letters.During the 1,3,6 and 12 months after treatment,the mean CMT were all decreased with statistically significant difference (F=43.726,P＜0.01).At 12 months,the retinal fluid of 34 eyes (91.9％) were absorbed completely;33 eyes (89.2％) had angiographic closure at that time.There was no significant relevance between BCVA improvement and sex,age and course of the disease (P＞0.05),but a significant negative correlation was found between the BCVA improvement and BCVA at baseline,injection times (P＜0.05).There was no significant relevance between CMT reduction and sex,age,course of the disease and injection times (P＞0.05),but a significant positive correlation was found between CMT reduction and CMT at baseline (P＜0.05).There were no systemic or ocular serious side effects during the follow up.Conclusions Intravitreal injections of Conbercept showed BCVA improvement and CMT reduction.It appeared to be effective and safe for choroidal neovascularization secondary to pathologic myopia.Intravitreal Conbercept for CNV secondary to PM showed BCVA improvement,CMT reduction and safety.

Objective To evaluate the effectiveness and safety of dexmedetomidine for the sedation of the patients after coronary artery bypass grafting (CABG).Methods The selective 96 CABG patients,ASA Ⅱor Ⅲ,aged 36 to 68 years old,58 males and 38 females,were randomly divided into 2 groups (n =48):dexmedetomidine group (group A) and midazolam group (group B).Group A patients received Dexmedetomidine (1.0 μg/kg)over 10 min,followed by 0.2-0.7 μg · kg-1 · h-1 to maintain sedation,whereas the other group patients received midazolam (0.05 mg/kg) over 10 min,followed by 0.02-0.10 mg · kg-1 · h-1 to maintain sedation.Two groups of patients stopped using drug when they were fit off-line and extubation.Observe the percentage of time within target sedative scope (Riker range 3-4),the changes of vital signs before and after treatment,the prevalence of delirium,the awakening time,the duration of mechanical ventilation,ICU length of stay,the adverse events of blood pressure and heart rate.Results There were no significant difference in the percentage of time within target sedative scope between two groups (75.5％ for dexmedetomidine group vs 74.6％ for midazolam group,P ＞ 0.05).Compared to midazolam group,the Dexmedetomidine group has a shorter awakening time [(14.0 ± 6.2) min for dexmedetomidine group vs (50.4 ± 12.8) min for midazolam group,P ＜ 0.05] and duration of mechanical ventilation,and also the prevalence of delirium was lower(15.3％ for dexmedetomidine group vs 34.6％ for midazolam group,P ＜0.05).ICU length of stay was similar.Dexmedetomidine-treated patients were more likely to develop bradcardia,with a non significant increase in the proportion requiring treatment,but had a lower likelihood of tachycardia or hypertension requiring treatment.Conclusion Dexmedetomidine is safe and effective in patients after CABG surgery.

Objective To compare the sensitivity and specificity of NMP 22 test with voided urine cytology in detection of bladder cancer and to evaluate their clinical values. Methods For 155 patients suspected with bladder cancer NMP 22 and cytology were conducted in the same voided urine samples.Of them 95 patients with bladder transitional cell carcinoma were confirmed histologically.The sensitivity and specificity of NMP 22 and urine cytology were analyzed.60 patients without bladder cancer were selected as control. Results The overall sensitivity and specificity of NMP 22 test were 65.3% and 70.0%,respectively,those of urine cytology were 43.2% and 83.3%,respectively.There was no significant difference between the specificity of urine cytology and that of NMP 22 test;however,NMP 22 was significantly more sensitive than urine cytology in detection of any stages and grades of bladder cancer(P

Objective To outline the diagnosis and treatment of a through-and-through urinary bladder to rectum-anal canal injury. Methods To review and summary 13 cases of through-and-through urinary bladder to rectum-anal canal injury.All patients were male and average age of 37 years old.Among them 4 cases reached hospital in 6 hours after injury,5 cases during 6～12 hours and 4 cases over 12 hours.Debridment and suture of urinary bladder to rectum-anal canal injure,effective revolution of urine and stools and full drainage in anterior sacrum space were performed.All of the 13 cases experienced operation of bladder exploration and drainage.1 among them underwent prostate gland cuting off because of the prostate gland injury.Another received the operation of urethra anastomoses.Both of them keep on catheterizing after operation.The management of anus and rectum hurt:3 cases received clearing and sewing up the wounnd of anus sphincter.8 cases received the repair of rectum passing through the anus.4 cases were not given remedy.7 patients received placing double thimble in the gap before sacrum.4 patients recieved placing eduction tube in the original wound.12 patients were given the operation of making sigmoid flexure fistula. Results All the 13 cases were cured.2 cases had postoperative infection in anterior sacrum space and were cured by full drainage.1 case was cured by secondary repairment after anal spincter repaired unsucessfully.1 case with rectovesical fistula was cured by conservative treatment.None suffered from dysuria,importence or anal stenosis.12 cases were visited and 1 was lost.Follow up was conducted from 10 months to 6 years.1 case with mild bowels incontinence recovered after training of lifting the anus for half a year.1 patient suffered from bladder calculi after a year and healed through lithotrity under cystoscope.The remaining 10 urinate and defecate normally,amonmg them 1 experienced urethra extends 6 times. Conclusions It was the key of improving treatment effect to master the clinical feature of a through-and -through urinary bladder to rectum-anal canal injury and diagnose correctly in the early stage and select reasonable operative procedure.