Fast-track surgery (FTS) protocols was introduced to reduce surgical stress and facilitate postoperative recovery.It has been more than 20 years since it had been proposed and it was successfully used in many special subjects such as orthopedic,upper gastrointestinal,gynecological,thoracic,vascular,endocrine et al,but the implication in radical cystectomy was insufficient.The propose of this article was to summarize the implication of FTS in radical cystectomy and to promote the development of the protocol in radical cystectomy.

Objective To explore the effects of anxiety-like behaviors on the levels of sex hormones and severity of erectile dysfunction(ED) in young men.Methods A total of 120 young men with ED,between the ages of 23 and 35 years,were prospectively studied,and all of them were the outpatients from the Affiliated Hospital of Jining Medical University from January 2012 to October 2013.Self-Rating Anxiety Scale (SAS) was used.According to the scores of SAS,the patients were divided into four groups.26 were rated by SAS as in the normal,36 in the mild,32 in the moderate and 26 in the severe state of anxiety.The levels of serum sex hormone (FSH,LH,PRL,T,E2) were detected by immunochemiluminometric assays.ED was assessed using the IIEF-5.Further,the responses were divided into three diagnosing groups on the basis of cutoff scores for IIEF-5.The relationship between the SAS scores of measuring anxiety,serum sex hormone levels,and the indicators for ED,Spearman rank correlations were carried out.Results Comparing with the normal control group,the levels of serum sex hormones (FSH,LH,PRL,E2) increased in other groups,but there were no significant differences (F=0.28,P=0.08 ; F=2.91,P=0.06; F=0.90,P=0.44; F=0.80,P=0.15).The levels of serum testosterone and the scores of IIEF-5 in the moderate and severe anxiety group decreased.The more severe symptoms of anxiety,the more likely that the ED would occur(x2=72.423,P=0.00),and ED was significantly positively correlated with anxiety(r=0.637,P=0.00).Testosterone played the partial intermediary role on the relationship between anxiety score and the IIEF-5 score.Conclusion Anxiety may contribute to ED through disturbing the sex hormone and lowering the level of serum testosterone.

Objective To study the effect of behavioral therapy combined with Paroxetine in the treatment of overactive bladder accompanied by depression and anxiety.Methods Over the past two years,a total of 69 cases of patients with overactive bladder accompanied by depression and anxiety were diagnosed by outpatient,they were divided into experimental group (n=33)and control group(n=36).The experimental group were given behavior therapy and Paroxetine in the treatment of anxiety,depression,while the control group were given behavior therapy.Then the overactive bladder symptom score(OABSS),urgency score,SDS,SAS score before and after treatment of the two groups of patients were statistically analyzed.Results (1)The OABSS score ((3.30± 1.01) vs (7.51 ± 0.69)),urgency score((2.60±0.51) vs (3.93±0.69)),SDS score((43.1±6.2) vs (66.4±4.7)) and SAS score ((41.9±0.6) vs (61.4±3.9)) decreased after treatment of the experimental group.There were statistically significant compared with before treatment(t=17.8773,8.9045,17.2039,16.0273,all P＜0.01).(2) The OABSS score,urgency score decreased after treatment of the control group.There were statistically significant compared with before treatment (t=6.1926,6.3483;both P＜0.01).SDS,SAS score before and after treatment of the control group were not statistically significant (t=1.3105,0.5852,bothP＞0.05) (3) The OABSS score,urgency score,of the experimental group were more depressed than the control group,which were statistically significant (t =3.3830,3.6391,both P＜0.01).Conclusion For overactive bladder patients with anxiety and depression,behavioral therapy combined with Paroxetine is better than behavioral therapy alone.

Objective To demonstrate a simple and cost-effective method to develop a telescopic renal sheath for treatment of complex kidney stones in percutaneous nephrolithotomy. Methods From October 2013 to October 2017, the clinical data of 94 patients with complex kidney stones and renal calyx diverticulum calculi who had underwent percutaneous nephrolithotomy were collected and were divided into two groups according with operation methods. In group A (45 patients), the 16F Peel-away sheath was inserted into the 20F outside sheath as the inner sheath. The stones were fragmented and removed through the telescopic renal sheath. In group B (49 patients), the stones were fragmented and removed through the 20F Peel-away sheath. The blood lose (hemoglobin decrease), operation time, rate of stone clear and perioperative complication between two groups were compared. Results All patients completed operation. The operation time in group A was significantly shorter than that in group B:(75.9 ± 15.8) min vs. (87.1 ± 21.6) min, P＝0.005. The decreased level of hemoglobin was less than that in group B: (0.72 ± 0.57) g/L vs. (1.22 ± 1.13) g/L, P＝0.009. The rate of stone clear in group A was higher than that in group B: 93.33%(42/45) vs. 77.55%(38/49), P＝0.032. All patients in group A had mild hematuria, which resolved within 2 d, and none received blood transfusion.Two patients in group B received blood transfusion. A small proportion in group A (1/45) and group B(4/49) received perioperative anti-infection therapy and fever rates were similar in the two groups. There were no serious complications such as pneumothorax and intestinal injury. Conclusions Telescopic renal sheath in mini-percutaneous nephrolithotomy is an effective method to treat complex kidney stones and renal calyx diverticulum.

Infectious stones are produced by urease producing microorganisms, which have a fast generation rate, high recurrence and mortality rates, and are prone to complications related to infection. At present, the treatment of infectious stones includes surgical treatment and drug treatment, and the research on its treatment methods has become one of the hotspots in the field of urology. This article provides a review of the research progress in the treatment of infectious stones, with the aim of improving understanding of the treatment of infectious stones.