Purpose:To evaluate the efficacy of bladder p re servation treatment by concurrent neoadjuvant intra-arterial chemotherapy, radi otherapy and transurethral resection for patients with bladder cancer with muscl e invasion. Methods:Thirteen patients who were unfit for or unwilling to re ceive radical cystectomy were enrolled in this study. All patients had muscle in vasive transitional cell carcinoma of bladder(T 2-T 3). Patients were treated with neoadjuvant intra-arterial chemotherapy, radiotherapy and transurethral r esection. The chemotherapy regimen consisted of cisplatin 80 mg, epirubicin 50 m g and fluorouracil 1 g/camptothecin 30 mg. The average dose of radiotherapy was 30-50 Gy. Results:At the end of neoadjuvant therapy, 1 patient (7.69%) sh owed a complete response and 12 patients (92.31%) showed partial response; tran surethral resection was performed for residual tumors. All patients completed th e treatment and showed good tolerance. With a median follow-up of 26.46 months, local recurrence or distant metastasis occurred in 5 patients (38.46%). Recurre nt tumors were treated with transurethral resection or systematic chemotherapy a nd radiotherapy. Conclusions:concurrent neoadjuvant intra-arterial chemotherapy , radiotherapy and transurethral resection is a feasible and promising treatment for patients with bladder cancer with muscle invasion.

Objective To explore the effective mechanism of tumor necrosis factor-?(TNF-?) and interlukin-8(IL-8) in experimental lung damage by observing changes of TNF-? and IL-8 concentration in lung tissue during abdominal infection. Methods The cecal ligation and perforation were utilized to make the abdominal infection in rats.The rats were sacrificed respectively at 0,24,48,72,96 and 120 hours after operation. The pulmonary vascular permeability and the amount of different cells in bronchoalveolar lavage fluid(BALF) were examined. The concentrations of TNF-? and IL-8 in BALF, lung tissue and plasma were assayed. Results The pulmonary vascular permeability and the neutrophil percentage of BALF increased progressively. The concentrations of TNF-? and IL-8 significantly increased in plasma, lung tissue and BALF. Significant correlation was respectively present between the TNF-? levels and the IL-8 levels in lung and BALF. The levels of TNF-? and IL-8 in lung and BALF were not correlated respectively with those in plasma. Conclusions TNF-? and IL-8 may be implicated in the inflammatory reaction of lung during early stage of abdominal infection. Lung injury derived from intestinal infection could be early discovered through assaying TNF-? and IL-8 concentration in BALF.

Objective To explore the effects of ureteral stent on renal pelvic pressure and other urodynamic parameters. Methods Forty-one patients, 28 males and 13 females, with unilateral renal calculi and/or ureteral calculi were recruited in this study. The mean patient age was 47 years old (ranging from 20 to 72 years old). All cases were placed a 4.7 F ureteral stent and 16 F nephrostomy tube after minimal invasive pereutaneona nephrolithotomy (MPCNL). There was no hydronephrosis and residual crushed stone in the ureter after MPCNL in all cases. Renal pelvic pressure, intra-abdo minal pressure, detrusor pressure, bladder pressure changes during the filling and voiding phases with intravesical perfusion flow rate of 40 ml/min were recorded and analyzed. Results At the baseline, IPP0, IAP0, DP0 and BP0 were (33.1±17.0)cm H2O, (27.5±7.0)cm H2O, (3.3±2.9)cm H2O and (30. 9±7.2)cm H2O, respectively; At the maximum cystometric capacity during the filling phase, IPPvol, IAPvol Dpvol and Bpvol were (39.4±67. 3)cm H2O, (31.1±7.3)cm H2O, (10.7±6. 6) cm H2O and (41.6±10.3)cm H2O, respectively; At the maximum bladder pressure during the voiding phase, IPPmax, IAPmax Dpmax and Bpmax were (65.7±17.0)cm H2O, (33.7±9. 7)cm H2O, (41.9±7.8)cm H2O and (75.0±12. 8)cm H2O, respectively;There were statistical significance comparing between any of IPP0, IPPvol and IPPmax(P<0. 01). 27% (11/41)patients were with the pain in kidney area at voiding IPPmax (87.1±14.6) cm H2O, which was significantly higher than IPPmax (57.8±9.5)cm H2O of asyrnptomatic group (30 patients)(P<0. 01). In all cases, the renal pelvic pressure was higher than 40 cm H2O during the voiding phase. Conclusions Renal pelvic pressure increases during the filling phase after placing the ureteral stent, especially during the voiding phase. As renal function will be damaged by the high renal pelvic pressure, we should decrease the utilization of ureteral stent if possible. It is encouraged to remove the ureteral stent as early as possible.

OBJECTIVE:To summarize the effects of compound glycyrrhizin injection(GL)on hormone withdrawal syndrome(HWS)in SARS patients.METHODS:Using contrast design,the HWS of 134 cases of SARS who had received hormone theropy was retrospectively analysed.RESULTS:Administration of GL could descend the incidence rate of symptoms of HWS,of which the incidence rates of short breath and chest distress,the main symptoms of SARS patients,dropped from 24.5%and 22.6%to 3.6%(P≤0.01)and 7.1%(P≤0.05)and the incidence of asthenia,musculoarthragia and headache decreased from 13.2%,15.1%and 10.4%to 7.2%,14.3%and 0%respectively.The number of patients with elevated ALT reduced(P≤0.01).CONCLUSION:GL can decrease the incidence of HWS.

OBJECTIVETo understand the penetrability of trypan blue to the normal prostate as well as to the inflammatory prostate and the prostate with benign hyperplasia in rats.

METHODSSixty SD male rats were randomized into 4 groups: NP (normal prostate) group (n = 15), BP (bacterial prostatitis) group (n = 15), BPH (benign prostatic hyperplasia) group (n = 15), and BPH-BP (benign prostatic hyperplasia with bacterial prostatitis) group (n = 15). Five rats were taken from each group as non-staining controls (NC, n = 5 x 4) and the other 10 were injected by tail intravenation with 1% trypan blue and then the prostates were isolated from the rats killed by anaesthesia after 2 hours. The color of the prostates and other tissues of the animals were observed and the contents of the trypan blue in the tissues of the prostates were determined separately by colorimetry.

RESULTSApart from the tissues of brains and spinal cord the surface and the inner tissues of the prostates with NP, BP, BPH and BPH-BP from the rats injected with the dye were also dyed blue similar to that of the muscles, livers, intestines and others. The content of the trypan blue in the tissues of the prostates with NP, BP and BPH-BP was obviously higher than those with NP and BPH.

CONCLUSIONThe penetrability of trypan blue with properties of ionization and larger molecular weight is high in either the normal prostate or the prostate with BP, BPH and BPH-BP, and much higher in inflammatory prostate than in the normal prostate and the prostate with BPH.

Animals ; Coloring Agents ; pharmacokinetics ; Male ; Prostate ; metabolism ; Prostatic Hyperplasia ; metabolism ; Prostatitis ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Trypan Blue ; pharmacokinetics

Objective To evaluate the effectiveness of extracorporeal shock wave lithotripsy (ESWL), retrograde ureterolithotripsy(URSL) and percutaneous ureterolithotripsy(PCL) in the treatment of proximal ureteral calculi. Methods A total of 397 patients with proximal ureteral calculi treated by ESWL,URSL or PCL ftom September 2001 to December 2005 were retrospectively analyzed. Results Among 397 patients,83 patients with a mean stone size of 1.23 cm were treated by ESW L.Of then.13 patients transferred to URSL or ureterolithotomy and the stone-free rate of ESWL 1 month later was 65.7%(46/70).TWO hundred and thirteen patients with a mean stone size of 1.21 cm were treated by URSL and 101 patients with a mean stone size of 1.50 cm were treated by PCL.The stone-free rate of URSL and PCL 1 month after the treatment was 88.2%(172/195)and 96.9%(95/98),respectively.Eighteen patients in URSL group and 3 patients in PCL group trans-ferred to ureterolithotomy.ESWL had a statistically lower stone-free rate than that of URSL and PCL (P＜0.001),both in patients with stone size≤1 cm and＞1 cm.For patients with stone size＞1 cm,PCL achieved a higher stone-free rate than URSL(P=0.005).PCL also had a higher stone-free rate than URSL in treating patients with stone size≤1 cm but there was no statistical difference between them. Conclusions ESWL can still be used as first-line treatment choice for proximal ureteral stones less than 1cm.For patients with proximal ureteral stones larger than 1cm.URSL and PCL are more proper treatment modalities since they can achieve higher stone-free rate and have acceptable low complications.

Objective:To evaluate the clinical efficacy of fixation with TightRope plate combined with hollow screw in the minimally invasive surgery for fresh Neer type Ⅱ B distal clavicle fracture.Methods:From January 2014 to December 2018, 27 patients with fresh Neer type Ⅱ B distal clavicle fractures underwent minimally invasive surgery using TightRope plate and hollow screw for fixation. The distal clavicle fracture was repositioned, and then the medial and lateral margins of coracoid base were located by Kirschner wires. A 0.8 cm incision was made on the skin above the undamaged clavicle more than 1.0 cm from the innermost side of fracture line. Under the guidance of X-ray, after drilling needle and reaming on the clavicle and the coracoid base, the medial side of clavicle fracture was fixed by TightRope plate. After drilling needle obliquely from the anterior lateral margin to the posterior medial one at the distal clavicle, a hollow screw of 3.0 mm in diameter was used to fix the clavicle fracture.Results:All operations were successful. Patients were followed up from 12 to 24 months and bone union was achieved from 8 to 20 weeks. The range of motion of shoulder joint was nearly normal at about 8 weeks after operation. At the last follow-up, the curative effect was excellent in 25 cases and good in 2 cases according to Constant-Murley standard.Conclusion:The minimally invasive surgery with TightRope plate and hollow screw is effective for Neer type Ⅱ B distal clavicle fracture, with simple manipulation, less cosmetic defect, rapid function rehabilitation, and short hospital stay.

Objective:To summarize the clinical experience of extracorporeal membrane oxygenation (ECMO) for neonatal refractory respiratory failure in a single medical center of Southwest China.Methods:From June 2020 to November 2021, the clinical data of neonates with refractory respiratory failure who received ECMO in the neonatal department of our hospital were retrospectively reviewed. The neonates were assigned into the survival group and the deceased group.Their general profile, clinical diagnosis, laboratory tests, ECMO operation, complications and prognosis were compared.Results:Eight neonates were included with five successfully withdrawal of ECMO and survived (5/8). For the three deceased neonates, two discontinued treatment because of intraventricular hemorrhage (grade Ⅲ~Ⅳ) and one confirmed congenital adrenal hyperplasia. No significant differences existed between the survival and the deceased groups in oxygenation index (OI), ECMO preparation and operation duration, usage of heparin, red blood cell suspension, platelet and sedative/analgesic drugs, therapeutic hypothermia and ECMO-associated complications. However, the deceased group had high OI values ( P=0.001), low lactate clearance ( P=0.005), more urine output during the first 24 h after ECMO ( P=0.046) and more fresh frozen plasma usage ( P=0.038). None of the five surviving children had significant developmental delay and neurological abnormalities during the 1-year follow-up. Conclusions:ECMO is effective treating neonatal refractory respiratory failure. Reducing the risk of intraventricular hemorrhage during ECMO may improve the survival rate.