Objective: To evaluate the efficacy and prognosis of loop cutaneous ureterostomy (LCU) in the treatment of primary obstructive megaureter (POM) with severe hydroureteronephrosis (HUN) in infants under 1 year of age，so as to provide reference for infants unsuitable for stage-Ⅰ ureteral reimplantation. Methods: A retrospective analysis was conducted on 12 infants with POM and severe HUN treated with LCU in our hospital during Jan.2019 and Dec.2023.The clinical characteristics，surgical techniques，indications，postoperative complications，stage-Ⅱ surgical approaches，and follow-up outcomes were summarized. Results: All operations were successful，with an average operation time of (37.08±7.53) min (6 left-sided LCU and 6 right-sided LCU).During the mean follow-up of (10.12±2.70) months，all infants showed clinical improvement，with complete resolution or significant alleviation of hydronephrosis，reduced ureteral diameter，and increased renal cortical thickness.Complications included asymptomatic bacteriuria in 3 cases (25%) and urinary tract infection (UTI) in 1 case，all resolved with oral antibiotics.Four cases developed peristomal rashes，which improved with topical treatment.Eleven infants underwent stage-Ⅱ Cohen ureterovesical reimplantation at a mean age of (15.20±2.07) months.Notably，27.3%(3/11) required ureteral tailoring or plication during reimplantation，which reduced the risk of ischemic necrosis from excessive trimming.During the follow-up of (22.17±13.93) months，hydronephrosis and renal function improved，and no febrile UTI or bladder dysfunction occurred. Conclusion: LCU is a safe and effective method，which can provide adequate urinary drainage，relieve obstruction，stabilize renal function，and allow time for ureteral maturation and renal parenchymal recovery.LCU also facilitates subsequent stage-Ⅱ surgery by reducing ureteral dilation.

Objective? To investigate the application of information-motivation-behavior (IMB) model in nursing care for patients with long-term indwelling bladder stoma. Methods? Totally 86 patients receiving long-term indwelling bladder stoma in the Department of Urinary Surgery, the Seventh Medical Center of Chinese PLA General Hospital from October 2015 to September 2017 were selected and divided into the control group (n=43) and the observation group (n=43) according to the random number table. Patients in the control group received conventional nursing care, while patients in the observation group received IMB-based health education on this basis. The self-care ability and quality of life of the two groups were assessed, and the incidence of complications during the follow-up was compared between the two groups after 12 months. Results? The scores of self-care ability, self-responsibility, self-conception and health knowledge as well as the total score after 12 months' nursing care were higher than those before treatment. The scores of the observation group were (43.18±4.32), (24.21±2.24), (26.04±2.63), (49.79±3.89), and (143.22±6.82), higher than those of the control group, which were (31.26±3.58), (16.74±1.55), (22.71±1.68), (38.67±1.92), and (109.38±5.04), and there were statistically differences between the two groups (P＜0.05). The total incidence rate of complications of the observation group was lower than that of the control group (6.98% vs. 37.21%,P＜0.05). Conclusions? The IMB model can enhance the self-care ability of patients with long-term indwelling bladder stoma, reduce the incidence of complications, and improve their quality of life effectively, which is worth promoting in clinical practice.

Objective To explore the effects of comfort nursing interventions on clinical effects and negative emotions in patients receiving transurethral plasmakinetic resection of the prostate(PKRP).Methods A total of 94 patients with benign prostatic hyperplasia(BPH)were selected and randomized into a control group(n=47)and an observation group(n=47)from May 2013 to June 2015.All the patients received PKRP.Patients in the control group received conventional nursing care,while patients in the observation group received perioperative comfort nursing interventions in addition to conventional nursing.The changes in the patients' blood pressure and heart rate were detected;SAS and SDS were used to evaluate their anxiety and depression levels post operation;relevant clinical indicators were measured and compared between the two groups to evaluate their short-and long-term clinical effects;and the incidence of complications and satisfaction were compared between the two groups.Results Compared with control group,the systolic pressure,diastolic pressure,average arterial pressure and heart rate of the oberservation group were lower,and SAS and SDS scores in the patients of the oberservation group were lower postoperatively(P < 0.05).The time of bladder irrigation,catheter indwelling,operation and hospital stay was shortened in the patients in the observation group as compared to the control group(P < 0.01).International prostate symptom score(IPSS)and residual urine volume decreased 3 months post operation,while the maximum urine flow rate and quality of life score(QLS)increased compared with preoperative conditions(P<0.05).The satisfaction and the incidence of complications following nursing interventions were 95.74％and 12.77％for the patients in the observation group and 78.72％and 40.43％for the patients in the control group,respectively(P < 0.05).Conclusions Comfort nursing interventions can improve the psychological state of PKRP patients,enhance their short-and long-term effectsand satisfaction,and reduce the incidence of related complications.

Objective To analyze the bone metabolism in hospitalized patients with Graves disease and the changes after 131I therapy.Methods The differences of bone metabolism were analyzed between 315 patients with Graves disease and 300 normal controls in a case-control study.The changes in bone turnover markers and BMD levels before and one year after 131I therapy were observed in 60 patients.Results Compared to normal control,bone turnover markers were markly higher and BMD levels were lower in patients with Graves disease.The level of thyroid hormones were positively related to bone turnover markers,while negatively related to total hip BMD (Z-score).But there was no linear relationship with lumbarand femoral neck BMD (Z-score).After one year of 131I therapy,bone turnover markers were markly lower than that before treatment,while BMD levels were partly higher than that before treatment.Conclusions In Graves disease patients,bone turnover markers were generally increased,while BMD levels decreased compared with normal people.After 131I therapy,along with the improvement of thyrotoxicosis,the high bone turnover rate can be suppressed,and BMD can partly recover.

Objective To study the clinical effect and perioperative nursing of holmium laser lithotripsy under ureteroscope ( PCUL) in the treatment of isolated kidney stones. Methods A total of 32 patients with isolated kidney stones were selected and their calculus were removed by using PCUL and meticulous perioperative nursing. Operation time, bleeding volume and stone clearance rate were observed; renal function changes before and 2 weeks after surgery were compared; anxiety and depression psychological state and pain before and after nursing were assessed; adverse events before and after nursing were recorded. Results The mean operative time was (89.7±2.18) min;average bleeding volume was (22.8±0.95) mL;totally 30 patients with stone clearance and the clearance rate was 93.75%; The levels of blood urea nitrogen ( BUN) and serum creatinine (Scr) were significantly reduced 2 weeks after surgery ( P<0. 01); Creatinine ( Ccr) rate was decreased slightly; The scores of anxiety, depression and pain were significantly reduced after nursing ( P<0.01) . The cases of hematuria, back pain, bladder irritation and infections were significantly reduced. Conclusions PCUL is safe and effective for the treatment of isolated kidney stones with high stone clearance rate, and combined with meticulous perioperative nursing can significantly improve patients′ anxiety and depression;reduce the incidence of postoperative complications and adverse events, and promote early recovery. It′s worthy of clinical use.

Objective To investigate the Effect of minimally invasive percutaneous ureteroscopic holmium laser lithotripsyl ( PCUL) in perioperative nursing and treatment of kidney stones of elderly patients. Methods A total of 96 elderly patients with nephrolith were divided into the control group ( n=50) and the experimental group ( n=46). Patients in the experimental group were treated with PCUL and perioperative nursing, while patients in the control group were treated with PCNL and routine nursing. Related index in clinical treatment was observed and compared in two groups. Postoperative pains and anxieties were evaluated by visual analogue scale ( VAS) , verbal rating scale ( VRS) and self-rating anxiety scale ( SAS) , and the surgical complications were recorded. Results Compared with the control group, the blood loss, operative time, hospitalization time, duration of hematuria of patients in the observation group were all significantly lower ( P<0.05) . Before the operation, there was no significant difference in serum creatinine level between two groups;3 and 6 months after operation, the serum creatinine level of patients in the experimental group was significantly lower than that in the control group (P<0.01). The VAS score and SAS score in the observation group after operation were lower than that in the control group ( P<0.01) . The ratio of patients without pain or mild pain in the observation group was higher than that in the control group;the ratio of patients with moderate or severe pain or torturing was lower than that in the control group ( P<0. 05 ) . In addition, the complication rate of experimental group was 26.09%, which was significantly lower than that of control group with a complication rate of 46.00% (P<0.05). Stone clearance rate in the observation group was 93.48% (43/46);the incidence rate of complications was 26.09% (12/46), and they were all lower than that in the control group (78.00%,46.00%) (P<0.05).Conclusions The combination of PCUL and perioperative nursing had an exact clinical effect in the therapy of elderly patients with nephrolith, which could significantly improve renal function, release the anxiety condition, shorter operative time, decrease the trauma and postoperative complications with a higher safety. In a word, the use of PCUL in the therapy of elderly patients with nephrolith is worthy of clinical application.

Objective:To provide some thoughts for pharmaceutical treatment and care for the patients with pulmonary infection af-ter renal transplantation. Methods:Clinical pharmacists participated the whole treatment process of one case of pulmonary infection af-ter renal transplantation. According to the literatures combined with medical history, clinical symptoms and lab results, the drug treat-ment process of the patient was analyzed, and the key points of the optimized pharmaceutical care were summarized. Results: The pharmaceutical care included the dose adjustment of immunosuppressants at the early phase of the disease and after the improvement of clinical symptoms, attention paid to the interactions between multiple anti-infective drugs and immunosuppressive agents, dosage ad-justment based on the renal function of the patient, monitoring adverse drug reactions and drawing up personalized regimen. Conclu-sion:Through comprehensive medication monitoring, clinical pharmacists can help physicians develop timely and effective treatment programs and provide professional and effective pharmaceutical care for patients.

This paper conducted research on biomechanical characteristics and biological activity of concavity-convex amniotic membrane (CCAM) and discussed its superiority as ocular surface repair material. Folding and compression with vacuum of fresh amniotic membrane were used to prepare CCAM. After cutting the striga of CCAM, sixteen CCAM tissue section were chosen at random to test their tensile strength using electronic universal testing machine. The bilayer amniotic membrane (BAM), the double-deck amniotic membrane (DAM) and the monolayer amniotic membrane (MAM) were as controls. The test parameters included yield strength, tensile strength, elongation at break, elastic modulus and so on. The cytokines of fresh amniotic membrane (FAM), MAM and CCAM were analyzed by radioimmunoassay method. The CCAM was obviously thicker than MAM and DAM. After 15 min in PBS, the CCAM tissue can recover the normal shape. The tensile strength and the elongation at break of CCAM were higher than those of the MAM and the DAM (P < 0.05). The elastic modulus of the CCAM was smaller than that of the MAM and the DAM (P < 0.05). The content of 10 cytokines [epidermal growth factor (EGF), fibroblast growth factor (FGF), b-fibroblast growth factor b-FGF, hepatocyte growth factor (HGF), transforming growth factor-beta (TGF-beta), insulin-like growth factor (IGF), platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), nerve growth factor (NGF), brain-derived nellrotrophic factor (BDNF), ciliary neurotrophic factor (CNTF)] of CCAM decreased significantly compared with the FAM and increased significantly compared with MAM and DAM in 6 cytokines (EGF, FGF, HGF, TGF-betap, PDGF, NGF; P < 0.05). The CCAM composites is thinner and has higher cytokine content than MAM, and better biomechanical properties than the MAM and the DAM, showing the superiority as ocular surface repair material.
Amnion ; chemistry ; physiology ; transplantation ; Biomechanical Phenomena ; Cytokines ; analysis ; Epidermal Growth Factor ; analysis ; Fibroblast Growth Factors ; analysis ; Hepatocyte Growth Factor ; analysis ; Humans ; Tissue Engineering ; methods ; Tissue Scaffolds

Objective To analyze the correlation between the expression of HIF-1α in multiple myeloma (MM) and clinical indexes in order to illustrate the expression and implication of HIF-1α gene in MM. Methods RQ-PCR method was used to amplify HIF-1α mRNA of bone marrow mononuclear cells isolated from 28 cases of MM patients and the control group. β-actin was used as internal standard. HIF-1α mRNA expression was analyzed by SDS software and the ratios of HIF-1α/ β-actin were calculated. Results The relative expression level of HIF-1α mRNA in MM bone marrow mononuclear cells was 12.68 times as that in control group. HIF-1α mRNA was positively correlated with β2-MG (r =0.575, P =0.000), ESR (r =0.522,P =0.000), LDH (r=0.286, P=0.044) and CRP (r =0.356, P =0.011). There was a negative correlation between HIF-1α mRNA and Hb (r =-0.556, P =0.000). Conclusion The expression of HIF-1α mRNA was up-regulated and HIF-1α was related to a number of clinical indexes. HIF-1α may be used to estimate the progress of MM and hopeful to be a new molecular target in cancer therapy.

FGF21 (fibroblast growth factor 21) is a recently described member of the FGF family. It has been previously demonstrated that FGF21 is a potent regulator of glucose homeostasis. To improve stability of FGF21 for better efficacy, a new form of recombinant FGF21 was generated by fusion of a full length FGF21 gene and the Fc fragment of human IgG4 with flexible linker sequence. To examine the glucose regulation activity of FGF21-L-Fc, 3T3-L1 pre-adipocytes were differentiated into adipocytes, and glucose uptake activity of FGF21-L-Fc was examined by glucose oxidase and peroxidase (GOD-POD) assay. The results showed that in comparison with wild type FGF21, FGF21-L-Fc was more potent in stimulation of glucose uptake by 3T3-L1. In vivo studies on the modified protein demonstrated that FGF-L-Fc had a better efficacy in lowering blood glucose of the STZ-induced diabetic animals and controlled glucose level for a longer time. The results provided a sound basis for further studies.