Objective To assess the therapeutic efficiency of short anterior urethral stricture treated with endourethral surgery combined with iridium 192 radiation therapy in order to decrease the recurrence rate after endourethral surgery. Methods A total of 286 patients with anterior urethral stricture (stricture length ranging from 0.5 to 2.5cm, averaging at 1.6cm) were divided randomly into two groups after internal urethrotomy and cicatrix electrotomy. The radiation group of 173 patients was treated as soon as possible with iridium 192 radiation therapy on the stricture sections while the control group of 113 patients was not. The recurrence rate was compared between the two groups during one year's follow-up. Results Among all the 286 successful operations, stricture recurred in 19 patients of the radiation group (recurrence rate of 10.98%) and in 62 ones of the control group (recurrence rate of 54.86%), with a significant difference (P=0.003). Conclusion It is an effective way to prevent recurrence by treating patients as early as possible with iridium 192 radiation on the stricture sections after endourethral operation on anterior urethral stricture.

Objective To investigate the molecular mechanism of the glucocorticoid?induced osteoblasts apoptosis,and to develop the effective intervention measures. Methods The MC3T3?E1 cells were treated with different concentrations of dexamethasone for 24 hours,then the apoptosis rate was detected with TUNEL analysis,the intracellular expression of Bim and Bax were determined by Westen blot. In addition,MC3T3?E1 cells were randomly divided into Bim?siRNA group,negative control siRNA group and control group. Twenty?four hours after transfection,10-4mmol/L dexamethasone was added to each group of cells for another 24 hours administration. The apoptosis rate was analyzed using the TUNEL,the mito?chondrial transmembrane electric potential was detected by flow cytometry after JC?1 staining,the expression of Bax,Bcl?2 in mitochondrial and Cyt?C,AIF in cytosolic were determined by Western blot. Results The rate of osteoblast apoptosis and Bim expression in cells were both significantly in?creased with the dosage of dexamethasone,there was no significant difference between the groups in the expression of Bax;the rate of osteoblast apop?tosis after the expression of silence Bim was significantly lower than the negative control siRNA group and control group,the expression of Bax and Cyt?C,AIF in cytosolic were significantly reduced,and the mitochondrial transmembrane electric potential was increased. Conclusion Bim is the key molecules in hormone?induced apoptosis of osteoblasts ,the expression of silence Bim can inhibit dexamethasone induced osteoblasts apoptosis through the mitochondrial pathway.

Objective: To observe the effects of recombinant adenovirus TRAIL (AdS-TRAIL & Ad5F35-TRAIL) on apoptosis of non-small cell lung (NSCLC) cells, so as to assess the value of Ad-TRAIL in gene therapy of NSCLC. Meth-ods: CAR and CD46 expression levels in lung cancer cell lines (A549, Z793, QG56 and NCI-H520) and the primary lung cancer cells from samples of 10 NSCLC patients were assayed by flow cytometry analysis. The lung cancer cell lines and primary lung cancer cells were infected with Ad5-TRAIL & Ad5F35-TRAIL adenoviral vectors at MOI 10 or 50, re-spectively; the percentage of apoptosis cells labeled by Annexin V-FITC in different cells were measured by flow cytometry 48 h after transfection. Results: The expression of CD46 were higher than that of CAR in all the lung cancer lines (A549, Z793, QG56 and NCI-H520) and the primary lung cancer cells. Significant apoptosis was observed in Z793 and QG56 cells transfected with Ad5-TRAIL or Ad5F35-TRAIL at MOI 10, with the apoptosis rate being (1.76±2.10)% (Ad5-TRAIL), (15.96±2.89) % (Ad5F35-THAIL) and (6.05±1.58) % (Ad5-TRAIL), (10.11±1.26) % (Ad5F35-TRAIL), respectively, compared to no adenovirus-transfected cells ([2.33±0.37] % and [5.95±1.89]%, respectively, P < 0.05). Less than 10% of apoptosis cells were detected in NCI-H520 cells transfected with Ad5- or Ad5F35-TRAIL at MOI 50 ([12.89±3.2] % for AdS-TRAIL and [9.08±1.35]% for Ad5F35-TRAIL, respectively) compared to no adenovirus-transfected cells ([7.04±2.17] %, P > 0.05). Moreover, apoptosis induced by Ad5- or Ad5F35-TRAIL transfection in A549 cells was not detected both at MOI 10 and 50. About half of the primary lung cancer cells from 10 patients induced apoptosis after transfected with Ad5-TRAIL or Ad5F35-TRAIL vector. A higher percentage of apoptotic cells were found in Ad5F35-TRAIL group than those in Ad5-TRAIL and control groups. Conclusion: Ad5-TRAIL can induce apoptosis of NSCLC cells in vitro, and Ad5F35-TRAIL is more potent than Ad5-TRAIL, so Ad5F35-TRAIL is more suitable for gene therapy of NSCLC.

Objective To establish the benign prostatic hyperplasia evaluation index system for nursing quality. Methods Indicators framework for perioperative nursing quality evaluation index system was built up by the theoretical research, clinical research, expert meetings approach firstly, then the Delphi method was used to screen and verify the indicators. Results Two rounds of consultation questionnaires were collected with rate of 86.0%, 95.3% respectively, the first round of consultation had the retention of 13 indicators, removed 4 indicators of those. After the second round, the average score of important target was no less than 8.0, and more than half of indicators had a full mark, coefficient of variation targets no higher than 0.20 were up to 100%. Coefficient of concordance of two rounds were 0.241 and 0.433 respectively. ConclusionsAfter two rounds of consultation, there were 13 quality indicators left and experts had well authoritativeness and representative.

Objective To investigate the clinical value of transrectal ultrasound-guided improved 13-core prostate biopsy in the detection of prostate cancer.Methods Retrospective analysis was conducted in the clinical data of 82 clinically suspected prostate cancer patients in Shaanxi Provincial People's Hospital from October 2015 to October 2016.All patients were undergone transrectal uhrasound-guided improved 13-core prostate biopsy and surgical treatment,and the prostate biopsy results were compared with the postoperative pathological results.The accuracy of the improved 13-core prostate biopsy and the standard 6-core prostate biopsy was compared.The complications of improved 13-core prostate biopsy were also discussed.Results The diagnostic results of prostate biopsy included prostate cancer in 26 patients and benign prostatic hyperplasia (BPH) in 54 patients.The diagnostic results of 80 patients are consistent with postoperative pathological examination.Two patients were diagnosed as BPH by biopsy,but confirmed to be prostate cancer by postoperative pathological examination.The accuracy of the improved 13-core prostate biopsy and the standard 6-core prostate biopsy were 97.6％ (80/82) and 84.1％ (69/82) respectively,and the difference showed statistical significance (P =0.023).No severe complications were found in patients who underwent transrectal ultrasound improved 13-core prostate biopsy.Conclusion Transrectal ultrasound guided improved 13-core prostate biopsy can increase the detection rate significantly.It is safe and efficacious,and can be widely used in clinic.

Objective To study nursing of ureteral calculi patients treated by holmium laser lithotripsy by ureteral soft mirror under general anesthesia.Methods A total of 118 patients with ureteral calculi in our hospital were randomly divided into control group and observation group according to the double blind number method,all patients carried out general anesthesia by soft ureteral holmium laser lithotripsy,the control group was given routine nursing care and the observation group was given intensive care.And the nursing results of patients were statistically analyzed.Results The observation group had higher one-time success rate of clear stone than the control group (91.53％ vs.81.36％,P ＜ 0.05);The incidence rates of complications in the observation group was 3.39％,which was significantly lower than 8.47％ in the control group(P ＜0.05).The hospitalization time,SDS score,VAS score and SAS score of the observation group were significantly better than that of the control group (P ＜ 0.05).The observation group had significantly higher related knowledge and treatment compliance than that in the control group(88.14％,91.53％ vs.76.27％,74.58％,P ＜0.05).Conclusion Holmium laser lithotripsy by ureteral soft mirror under general anesthesia can strengthen treatment cooperation,the awareness of related disease knowledge,improve the rehabilitation effect of patients,and it is worth of popularizing.

Objective To analyze the effect of perioperative systemic nursing for laparoscopic radical nephrectomy patients.Methods A total of 90 patients with laparoscopic radical nephrectomy undergoing laparoscopic surgery were randomly divided into observation group and control group,with 45 cases in each group.The observation group used the perioperative whole systematic nursing,the control group traditional nursing.The therapeutic effect,postoperative pain,SAS score,SDS score and postoperative complications were compared between the two groups.Results The total effective rate of the observation group was significantly higher than that of the control group (97.78％ vs.84.44％,P ＜ 0.05);The number of patients with 0,Ⅰ pain was more,and grade Ⅱ and Ⅲ pain patients in observation group were significantly less than that in the control group (P ＜ 0.05);SAS scores and SDS scores of the two groups after treatment decreased compared with treatment before,and the observation group was significantly lower than the control group (P ＜ 0.05);The postoperative complication rate in the observation group was significantly lower than that in the control group (P ＜ 0.05).Conclusion Perioperative systemic nursing measures can improve the curative effect of laparoscopic radical nephrectomy,relieve the pain and negative mood of patients,and reduce the incidence of complications.

Retrovenal ureter is a type of inferior vena cava mutation. Retrovenal ureter with right double inferior vena cava mutation is rare. We reported a case of retrocaval ureteral with right double inferior vena cava variation, right ureteral calculi and hydronephrosis of the right kidney. Peritoneal laparoscopic ureterolithotomy and right posterior vena cava dissection ureteroplasty were performed. Fourteen months after surgery, B-ultrasound of the urinary system was reexamined, and no hydronephrosis was found in the right renal pelvis and ureter.

This paper reviewed the research progress on vascular access information system from two aspects including development and advantages of vascular access information system both here and abroad.This paper focused on expounding the achieving functions of vascular access information system at present,so as to provide a basis for developing a vascular access information management platform and a reference for promoting the standardized management of the trinity of hospital-community-family vascular access.

Objective To study nursing of ureteral calculi patients treated by holmium laser lithotripsy by ureteral soft mirror under general anesthesia.Methods A total of 118 patients with ureteral calculi in our hospital were randomly divided into control group and observation group according to the double blind number method,all patients carried out general anesthesia by soft ureteral holmium laser lithotripsy,the control group was given routine nursing care and the observation group was given intensive care.And the nursing results of patients were statistically analyzed.Results The observation group had higher one-time success rate of clear stone than the control group (91.53％ vs.81.36％,P ＜ 0.05);The incidence rates of complications in the observation group was 3.39％,which was significantly lower than 8.47％ in the control group(P ＜0.05).The hospitalization time,SDS score,VAS score and SAS score of the observation group were significantly better than that of the control group (P ＜ 0.05).The observation group had significantly higher related knowledge and treatment compliance than that in the control group(88.14％,91.53％ vs.76.27％,74.58％,P ＜0.05).Conclusion Holmium laser lithotripsy by ureteral soft mirror under general anesthesia can strengthen treatment cooperation,the awareness of related disease knowledge,improve the rehabilitation effect of patients,and it is worth of popularizing.