Prostate cancer, bladder cancer, and rectal cancer are common malignancies in the male pelvis. The incidence rate of erectile dysfunction (ED) following radical prostatectomy, cystectomy or rectal cancer surgery is about 25% - 100%. The main cause of post-surgery ED is mainly attributed to injury of neurovascular bundles, which may lead to reduced oxygenation in and fibrosis of the penile tissue. Early penile rehabilitation after surgery can improve or restore the erectile function of the patients. This article focuses on penile rehabilitation after radical pelvic surgery.
Cystectomy ; Erectile Dysfunction ; etiology ; rehabilitation ; Humans ; Male ; Pelvic Neoplasms ; surgery ; Penile Erection ; Penis ; Postoperative Complications ; rehabilitation ; Postoperative Period ; Prostatectomy ; adverse effects ; Prostatic Neoplasms ; surgery ; Rectal Neoplasms ; surgery ; Urinary Bladder Neoplasms ; surgery

Objective To investigate the detection of multidrug-resistant organisms (MDROs)in a hospital, evaluate the efficacy of multi-disciplinary team(MDT)on management of MDROs,and provide guidance for effective control on MDRO infection.Methods From October 2013 to September 2014,compliance to comprehensive inter-vention measures in clinical departments in different stages as well as detection of MDROs from patients were com-pared respectively.Results Compliance to comprehensive intervention measures showed an overall upward trend from the fourth quarter of 2013 to the first,second,and third quarters of 2014,difference was statistically signifi-cant (all P <0.001 ).From the fourth quarter of 2013 to the third quarter of 2014,the percentage of the major MDRO strains in the same species of bacteria were:methicillin-resistant Staphylococcus aureus (MRSA)52.34%, 45.45%,48.95%,and 26.25% respectively;carbapenem-resistant Acinetobacter baumannii (CRAB)64.42%, 63.07%,59.87%,and 43.09% respectively;multidrug-resistant Pseudomonas aeruginosa (MDRPA)42.11 %, 41 .82%,29.33%,and 17.52% respectively;the detection rate of MRSA,CRAB,and MDRPA showed an overall downward trend,difference among different stages were statistically significant (all P <0.001 ).Detection rates of carbapenem-resistant Enterobacteriaceae (CRE)and vancomycin-resistant Enterococcus (VRE)were both low (<5%),difference among different stages were not statistically significant (all P >0.05).Conclusion MDT on man-agement of MDROs is helpful for reducing the emergence and spread of MDROs.

AIM:To study the induction of apoptosis by c-myc antisense oligonucleotide in osteosarcoma cell(MG-63).METHODS:The designed c-myc antisense oligonucleotide fragment was transfected into human osteosarcoma MG-63 cells.The cell growth and apoptosis were measured by the methods of MTT,FCM,HE staining and transmission electron microscopy.RESULTS:The results showed that the proliferation of human osteosarcoma MG-63 cells was inhibited and apoptotic rate was 37.92% when treated with c-myc antisense oligonucleotide at the does of 10.0 ?mol/L for 48 h.c-myc antisense oligonucleotide(10.0 ?mol/L) also inhibited the expression of c-myc protein.CONCLUSION:c-myc antisense oligonucleotide is able to induce apoptosis in human osteosarcoma MG-63 cells.

Objective To evaluate the long-term outcome of acute kidney injury (AKI) during hospitalization after cardiac surgery.Methods 1 770 patients underwent cardiac surgery in Fudan University Zhongshan Hospital from April 2009 to February 2011 were enrolled.Based on the Kidney Disease:Improving Global Outcomes (KDIGO) guideline of AKI,the patients were divided into the AKI and the nonAKI groups,and followed up for 2 years.The 2-year survival rate and incidence of the advanced chronic kidney disease (CKD) was compared between the two groups.Factors influencing the 2-year survival rate and incidence of the advanced CKD were also analyzed.Results Among all the patients,715 (40.4％) of them were developed AKT.(1) The 2-year survival rate of the AKI group was lower than that of the non-AKI group (83.2％ vs 93.6％ ;P ＜0.05).Compared with the non-AKI group,AKI group had an increased risk for death with the hazard ratio of 1.710 (95％ CI 1.250-2.340).COX regression analysis showed that AKI was an independent factor for death with the risk intensity just less than diabetes and chronic cardiac insufficiency.The advanced age,the preoperative history of chronic cardiac insufficiency and the time of staying in ICU also significantly increased the risk of death.(2) Compared with patients without AKI (0.2 ％),the incidence of the 2-year of advanced CKD was higher in patients with AKI (6.7 ％ ; P ＜ 0.05) with an hazard ratio of 31.220 (95 ％ CI 7.550-129.110).COX regression analysis showed that AKI was still the independent risk factor for advanced CKD after adjustment of other factors.In addition,diabetes,the time of the cardiopulmonary bypass and the time of staying in ICU were also associated with the risk for the advanced CKD.Conclusions AKI is common after cardiac surgery,which was associated with a decrease in the 2-year survival rate and an increase in the incidence of advanced CKD of patients,which emphasized the importance of prevention and treatment of AKI,and close follow-up of renal function for the improvement of patient long-term prognosis.

Objective To investigate the significance of combined vascular resection and reconstruction in surgery for pancreatic cancer.Methods The clinical data of 231 patients with pancreatic canccr who received pancreaticoduodenectomy at the Southwest Hospital from January 2006 to December 2011 were retrospectively analyzed.All the patients were divided into the combined vascular resection and reconstruction group (97patients) and non-vascular resection and reconstruction group (134 patients).Effects of operation,results of pathological examination,prognosis and lymph node metastasis on the prognosis of the patients in the 2 groups were compared.Two independent samples t test was used to analyze the measurement data,and the count data were analyzed using the chi-square test.The survival curve was drawn by the Kaplan-Meier method,and the survival was analyzed using the Log-rank test.Results The operation time and intraoperative volume of blood loss were (554 ± 136)minutes and (1110 ± 939)rnl in the combined vascular resection and reconstruction group,and (445 ±106)minutes and (623 ±349)ml in the non-vascular resection and reconstruction group,with significant difference between the 2 groups (t =6.552,4.873,P ＜ 0.05).The mortality,morbidity and positive rate of lymph node metastasis of were 8.2％ (8/97),20.6％ (20/97) and 32.0％ (31/97) in the combined vascular resection and reconstruction group and 3.0％ (4/134),8.2％ (11 / 134) and 16.4％ (22/134) in the non-vascular resection and reconstruction group.There was no significant difference in the mortality between the 2 groups (x2=3.164,P ＞ 0.05),while significant differences in the morbidity and positive rate of lymph node metastasis were detected between the 2 groups (x2 =7.458,7.687,P ＜ 0.05).A total of 223 patients were followed up till September 2012,53 patients were with lymph node metastasis,and their median survival time was 8.4 months (range,6.9-10.0 months) ; 170 patients were with negative lymph node metastasis,and their median survival time was 18.6 months (range,15.8-21.5 months),which was significantly longer than that of patients with positive lymph node metastasis (x2=17.045,P ＜ 0.05).Of the 53 patients with lymph node metastasis,31 were in the combined vascular resection and reconstruction group,and their median survival time was 8.5 months (range,6.3-10.7 months) ; 22 were in the non-vascular resection and reconstruction group,and their median survival time was 8.3 months (range,6.1-10.5 months),with no significant difference between the 2 groups (x2 =0.022,P ＞ 0.05).Of the 178 patients with negative lymph node metastasis,64 were in the combined vascular resection and reconstruction group,and their median survival time was 13.2 months (range,9.2-17.1 months) ; 106 were in the non-vascular resection and reconstruction group,and their median survival time was 21.7 months (range,18.1-25.3 months),with significant difference between the 2 groups (x2 =11.908,P ＜ 0.05).Conclusions Although pancreaticoduodenectomy combined with vascular resection and reconstruction increases the incidence of postoperative complications,it could achieve the complete removal of tumors without significantly increasing the mortality rate.For patients with lymph node metastasis,pancreaticoduodenectomy combined with vascular resection and reconstruction has no influence on the postoperative survival time,while it might have influence on the patients without lymph node metastasis.

This study was aimed to develop a maximum a posteriori Bayesian (MAPB) estimation method to estimate individual pharmacokinetic parameters based on D-optimal sampling strategy. Meanwhile, the performance of MAPB was compared with the multiple linear regression (MLR) method in terms of accuracy and precision. Pharmacokinetic study of pioglitazone was employed as the example case. The population pharmacokinetics was characterized by nonlinear mixed effects model (NONMEM). The sparse sampling strategy (1-4 points) was identified by D-optimal algorithm using WinPOPT software. The simulated data generated by Monte Carlo method were used to access the performance of MAPB and MLR. As the number of samples per subject decreased, the accuracy and precision of MAPB method tended to get worse. The estimation for CL and Vby MAPB using D-optimal two-point design had less bias with low inter-individual variability, and had more bias and imprecision with high residue variability. The estimation of AUC by MAPB using D-optimal 2 points design had similar accuracy and precision to MLR. However, MAPB estimation was better than MLR while adjusting the sampling time to one hour. Overall, the MAPB method had similar predictive performance as MLR, but MAPB could provide more pharmacokinetic information with higher sampling flexibility.
Area Under Curve ; Bayes Theorem ; Humans ; Hypoglycemic Agents ; pharmacokinetics ; Linear Models ; Monte Carlo Method ; Nonlinear Dynamics ; Thiazolidinediones ; pharmacokinetics

Objective To investigate the situation of prevalence,treatment and control of hypertension in patients with chronic kidney disease(CKD)by CROSS-sectional study. Methods Nine hundred out-patients with CKD in our department from November 2006 to March 2007 were enrolled in the study,including 480 male and 420 female.Among 900 CKD cases,354 patients underwent maintenance dialysis,including 228 on hemodialysis and 126 on peritoneal dialysis.Results The prevalence of hypertension in CKD patients was 80.2%(nude 83.5%vs female 76.4%,P<0.01).The prevalence of hypertension in patients on dialysis was significantly higher than that in non-dialysis patients(90.1%vs 73.8%,P<0.01),but there was no significant difference between hemodialysis and peritoneal dialysis cases.Antihypertensive treatment rate was 92.4%in CKD patients with hypertension.and was significantly higher in patients on dialysis than that in non-dialysis patients(95.6%vs 89.8%.P<0.01).The control rate according to current recommendations for CKD patients (BP<130/80 mm Hg) was very low. Control of both SBP and DBP was only achieved in 20.4% of non- dialysis patients. The control rate of hypertension (BP< 125/75 mm Hg) in patients with proteinuria >1 g/24 h was 8.4%. The proportion of dialysis patients with BP<140/90 mm Hg was significantly lower than that of non-dialysis patients (45.2% vs 55.5%, P<0.01). The percentage of hemodialysis patients with BP < 140/90 mm Hg was significantly higher than that of peritoneal dialysis patients (49.8% vs 36.5%, P<0.05). The prevalence of hypertension was associated with the decrease of renal function and the increase of age. The prevalence of hypertension in diabetic nephropathy was higher than that in primary glomerular diseases. Patients received 1, 2, 3 and 4 or more kinds of antihypertensive drugs accounted for 37.2%, 37.5%, 19.3% and 5.9% respectively. The combination of calcium channel blocker (CCB) and renin-angiotensin-aldosterone system (RAAS) inhibitors was more frequently used in CKD patients. The CCB was the most frequently prescribed drug (74.1% ), followed by angiotensin Ⅱ receptor blockers (ARB) (48.4%), angiotensin-converting enzyme inhibitors (ACEI) (25.6%) and alpha, beta-blockers (24.7%). Conclusions The prevalence of hypertension in CKD patients is quite high, which is associated with the progression of renal function, increase of age, the type of underlying kidney disease, obesity and diabetes mellitus. The control of hypertension is unsatisfied in CKD patients, especially in dialysis patients and those with overt proteinuria.

ObjectiveTo compare the efficacy and safety of intermittent patient-initiated single-dose antibiotic prophylaxis and continuous antibiotic prophylaxis for the prevention of recurrent urinary tract infection (UTI) in postmenopausal women. MethodsA randomized controlled clinical trial was conducted for the prevention of recurrent urinary tract infection. Single dose of antibiotic was given every night in continuous antibiotic prophylaxis group and every time after exposure to conditions predisposed to UTI in intermittent antibiotic prophylaxis group. The duration of prevention was 12 months in both groups. ResultsThe effective rates of intermittent antibiotic prophylaxis and continuous antibiotic prophylaxis were 71.0% and 81.8% respectively (P＞0.05). The incidence of gastrointestinal adverse reaction in intermittent antibiotic prophylaxis group was significantly lower than that in continuous antibiotic prophylaxis group (7.7% vs 28.6%,P＜0.05). ConclusionsCompared with continuous antibiotic prophylaxis, intermittent patient-initiated single-dose antibiotic prophylaxis is a better prophylaxis with less gastrointestinal adverse reactions for the prevention of recurrent urinary tract infection in postmenopausal women.

In order to meet the requirements of cultivating the practical abilities and creativities of students who receive higher education, we initiated the reformation of education in the microbiology experiment teaching methods, implementing a system for module-based education, carefully monitoring every link in teaching, combining the encouragement and strict requirements together, adopting a proper way of assessment. It is proven that the implementation of the educational reformation mobilizes the interests of students and enhances the comprehensive qualities of students, which accomplishes the purposes of teaching.