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Objective:To explore the feasibility, safety and clinical efficacy of ileum augmentation cystoplasty assisted by Da Vinci robot for the treatment of neurogenic bladder.Methods:Retrospective analysis was performed on the data of 12 patients with neurogenic bladder admitted to Zhejiang Provincial People’s Hospital from March 2017 to November 2018, including 11 males and 1 female, with the mean age of 38(12-67). Preoperative symptoms were urinary incontinence, dysuria, decreased bladder capacity, or increased bladder pressure leading to ureteral reflux. All the 12 patients underwent preoperative intermittent catheterization, including 8 patients with spinal cord injury and 4 patients with spinal cord dysplasia. Preoperative serum creatinine(129.58±44.60)μmol/L and total glomerular filtration rate(61.63±18.04)ml/(min·m 2) were observed in 12 patients. Preoperative urodynamic examination showed the safe bladder volume of (95.67±39.10)ml, bladder internal pressure of(63.30±6.02)cmH 2O(1 cmH 2O=0.098 kPa)at the end of filling period, bladder compliance of(10.24±1.14)ml/cmH 2O, residual urine volume of(152.58±80.89)ml, and urine flow rate of(3.88±3.63)ml/s. Bladder contracture was evident on preoperative cystography. Ultrasound examination showed different degree of hydronephrosis and ureter expansion, in all cases, with ureteral reflux grading Ⅰin 2 cases, grade Ⅱ in 4 cases, grade Ⅲ in 4 cases, grade Ⅳ in 2 cases. All the 12 patients underwent robot-assisted ileum augmentation cystoplasty with 5-point puncture. Transverse incision of the bladder wall before full thickness, according to the amount of bladder and quality to decide 30 cm(normal), longitudinal cut back loops and one point after suture fixation in the bladder wall midpoint, fixed point as starting point, in turn, will be blind to the bladder stitching on both sides, the bilateral ureteral placing a single J tube respectively, evaluation of surgical success rate (including intraoperative bleeding, interception of bowel loops are no damage adjacent viscera, ureter openings with and without damage, impermeability, match insufflate whether unobstructed), postoperative complications, anastomotic fistula, intestinal obstruction, abdominal bleeding), urine dynamics test parameters, and patients’ quality of life. Patients were regularly given anticholinergic drugs(2 mg/d) for 6 months after surgery. Results:All the 12 cases in this group were successfully completed without any transfer to open surgery. The operation time was(120.8±12.0)min. Intraoperative blood loss(84.0±23.2)ml. Postoperative intestinal function recovery time(3.3±1.3) d. Postoperative hospital stay(12.1±3.1)d. Postoperative pelvic drainage tube indwelling time (3.8±1.2) d. Catheter and single J tube were removed 2 weeks after operation. Postoperative follow-up averaged 19.4(3-24) months. At 3, 12, 24 months after surgery, the bladder safety volume was rechecked(435.83±33.56), (450.90±31.09), (462.00±33.72)ml, the bladder internal pressure at the end of filling was(18.60±0.92), (15.70±1.42), (12.96±1.34)cmH 2O, the blood creatinine level was(81.43±21.10), (74.34±15.70), (72.90±15.90)μmol/L, and the bladder compliance was(37.94±4.22), (40.40±3.98), (43.42±4.20)ml/cmH 2O and the total glomerular filtration rate(91.52±9.49), (102.18±5.65), (112.41±6.50)ml/(min·m 2) were significantly improved compared with those before surgery( P<0.001). After 24 months of bladder urination training, 1 patient could basically urinate by herself. Three patients were treated with intermittent urinary catheterization supplemented by automatic urination. The remaining 8 patients were completely dependent on urinary catheter for intermittent catheterization. Postoperative complications such as anastomotic fistula, ileus and abdominal bleeding were not found in 12 patients. Conclusions:Ileum bladder enlargement assisted by robot can effectively expand bladder volume, reduce bladder internal pressure, improve bladder compliance, prevent ureteral reflux and protect renal function.
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Bone graft is an important basic condition for repairing skull defect caused by various reasons,but whether autologous bone graft or allograft bone transplantation,the clinical limitations was increasingly significant.With the development of bone tissue engineering,the introduction of bone progenitor cells and growth factors into composite scaffolds made from natural or synthetic materials,and as a substitute for bone graft has become a hot spot of research.It will review the research progress on bone graft substitute and bone biomimetic scaffold material,so as to provides reference on the further investigations.
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Objective To compare the sensitivity,accuracy and specificity between automated breast volume scanner (ABVS) and ultrasonic elastography (UE) in the diagnosis of breast mass.Methods From May 2016 to July 2017,132 patients with breast mass in the No.266 Hospital of PLA were chosen in the research.ABVS,UE and two-dimentional ultrasonography were used for diagnosis,and the diagnostic results were compared with pathological results.Results The sensitivity,accuracy and the specificity of two-dimensional ultrasonography were 76.54％ (62/81),75.0％ (114/152),73.24％ (52/71),respectively,which of UE were 80.25％ (65/81),78.95％ (120/152) and 77.46％ (55/71),respectively,which of ABVS were 88.89％ (72/81),88.16％ (134/152) and 87.32％ (62/71),respectively.The sensitivity of ABVS was higher than that of two-dimensional ultrasonography (x2 =4.318,P＜0.05),while had no statistically significant difference compared with that of UE(x2 =2.318,P ＞ 0.05).The accuracy and specificity of ABVS were higher than those of UE and two-dimensional ultrasonography (accuracy:x12 =8.756,x22 =4.692;specificity:x12 =4.449,x22 =4.135;all P ＜0.05).Conclusion The sensitivity,accuracy and specificity of ABVS in the diagnosis of breast lesions are high,and doctors from ultrasonic department are recommended to use ABVS to diagnose breast cancer.This can improve the detectable rate of breast cancer and the cure rate and survival rate of patients.
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Objective@#To investigate the effects of sIL-13Rα2 on the apoptosis of goblet cell in nasal mucosa of allergic rhinitis rats.@*Methods@#Forty healthy male Wistar rats were randomly divided into 4 groups (10 rats per group): control group (group A), AR group (group B), sIL-13Rα2 group (group C) and triamcinolone acetonide group (group D). Ovalbumin (OVA) and aluminum hydroxide were used to establish the AR rat model. After the establishment of AR rat models, 50 μl PBS, 100 μg/50 μl IL-13Rα2 and 3.5 μg/50 μl triamcinolone acetonide were respectively dropped into each nasal cavity of every rat two times a week from 4 to 10 week in group B, group C and group D. Group A was operated with saline instead of OVA. The nasal mucosa tissues were collected at 24 h after the final administration. AB-PAS staining method was used to detect the quantity and secretion of goblet cells in the nasal mucosa tissue of all groups. Immunohistochemistry method was used to detect the expression of Bax proteins.Apoptosis was detected by TUNEL method.ANOVA analysis was used to compare multiple groups, and LSD-t test was used to compare the two groups.Pearson correlation analysis was used to analyze the correlation between the Bax positive cell rate of goblet cells and the rate of apoptotic cells. The difference was statistically significant with P<0.05.@*Results@#Compared with group A, there were more goblet cells and hypersecretion of mucus in the nasal mucosa tissue of rats in group B while fewer in group C. The goblet cells in group C and group D were significantly fewer than that in group B (0.639 00±0.831 vs 0.956 7±0.980, 0.661 90±0.657 vs 0.956 7±0.980, t value was 2.748, 2.767, respectively, all P<0.05). The immunohistochemistry results showed that the positive expression rates of Bax protein in goblet cells of group C and group D were significantly higher than that in group B (0.880 2±0.125 vs 0.568 7±0.953, 0.938 4±0.200 vs 0.568 7±0.953, t value was -2.292, -2.685, respectively, all P<0.05). The apoptosis rates of goblet cell in nasal mucosa of group C and group D were also significantly higher than that in group B (0.516 0±0.079 vs 0.274 0±0.056, 0.535 4±0.829 vs 0.274 0±0.056, t value was -17.671, -2.225, respectively, all P<0.05). The expression of Bax protein and apoptosis of goblet cells were positively correlated (r=0.859, P<0.01).@*Conclusion@#sIL-13Rα2 can induce apoptosis of the goblet cells in nasal mucosa of allergic rhinitis rats, by inhibiting IL-13 and up regulating Bax.
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Papers on medical informatics published in China and USA in the past 10 years were analyzed by co-word analysis using TDA and SPSS 20.0 respectively with Web of Science-covered core collection as the data source and the distribution of key words in the papers was analyzed by Ucinet and NetDraw respectively to mine the research hotspots, which showed consistencies and differences in medical informatics of the two countries.The con-sistencies were demonstrated in application of computer technologies in hospital management and clinical diagnosis and treatment while the differences were revealed in higher level of medical informatics, fuller use of medical infor-mation and data, the more perfection of medical informatics education system, and the higher level of EBM research in USA than in China.
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OBJECTIVE:To provide a reference for rational clinical application of Reduning injection. METHODS:The rele-vant information about the patients who sought treatment in our hospital in 2014 and used reduning injection were collected to make statistical analysis to the age,dosage,course of treatment,frequencies,etc. RESULTS:Among the above-mentioned patients,the number of males was more than that of females,children under 10 years old accounted for 36.10%,47.54%of patients received re-duning injection for a treatment course of over five days,and 14.99% of patients failed to wash the infusion tube before injection. CONCLUSIONS:Irrational clinical application of reduning injection exists. The administration and dosage should be standardized and the dosage for children under three years old as specified in the label be detailed to reduce and avoid the occurrence of adverse drug reaction so as to ensure the safety of drug use by patients.
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Objective To investigate the opportunity and methods of acute biliary pancreatitis.Methods A retrospective review was performed in 85 consecutive patients from June 2008 to October 2014 with acute biliary pancreatitis in Beijing Yanqing County Hospital.Results Eighty-five patients were performed operation.Sisty-two patients underwent laparoscopic cholecystectomy and laparoscopic transcystic common bile duct exploration.Fifyfourcases were found biliary calculi and take away the stones.All patients were no complications such as infection,bile leakage,hemorrhage,bile duct injury,cicatrical stenosis of papilla.After three months of follow-up without biliary residual bile stones and recurrent pancreatitis.Conclusions The early surgical treatment for no severe acute biliary pancreatitis is necessary,safe and feasible.Actively biliary tract exploration can avoid bile duct residual stones.
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Objective To investigate the effect of leptin on transcription factor nuclear-κB (NF-κB) activity of pancreatic tissue and blood inflammatory cytokines (TNF-α,IL-1β) in severe acute pancreatitis. Methods Thirty-six rats were randomly divided into three groups, including sham group (group A, n = 12), AP model group(group B, n = 12) and Leptin treatment group (group C, n = 12). SAP was induced by intraductal injection of 5% sodium taurocholate into the pancreatic duct. Exogenous leptin was injected I. P. Fifteen minutes later. The concentration of serum amylase, leptin, TNF-α, IL-1βwere measured by radioimmunoassay 6 hours later. NF-κB activity of the pancreatic tissue were measured by immunohistochemistry. The changes of pathology of the pancreas were observed. Results The levels of serum amylase, cytokine TNF-αand IL-1βwere significantly reduced in group C, and the levels of serum leptin were significantly increased in group C. NF-κB activity in the pancreatic tissue in group B were significantly higher than that in group A. However, NF-κB activity of the pancreatic tissue in group C were significantly lower than that in group B. Furthermore, the extent of necrosis of the pancreatic tissue was re-lieved. Conclusion Exogenous leptin protected the rats pancreas against damage by sodium taurocholate. The protective effects of exoge-nous leptin were attributive to the reduction in cytokines TNF-α, IL-1β. The possible protective mechanism was that leptin decreased NF-κB activity.
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OBJECTIVE:To facilitate the hierachical management and use of antibiotics and tighten control on prescription right on the narcotics drugs.METHODS:Hospital informational system has contributed to the informatization management on supervision of the prescriptions of antibiotics and narcotics.RESULTS:After half a year's practice of informatization management,remarkable outcome has achieved in that the practice of hierachical management and use of antibiotics has been improved significantly,and the management on the prescription right of narcotics drugs became more simple and reliable.CONCLUSIONS:Adopting hospital information system to tighten control on the prescriptions of antibiotics and narcotics drugs is a good management model in which various abnormal prescription behaviors can be effectively warned of and guard against from the very beginning.
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OBJECTIVE: To establish a method for the simultaneous determination of the contents of salicylic acid and nitrofural in Fu-La pastes.METHODS: A dual-wavelength spectrophotometry was adopted for the determination of the contents of salicylic acid and nitrofural with water used as solvent.The content of salicylic acid was determined with the detective wavelength set at 296.6 nm and the reference wavelength set at 314.4 nm.The content of the nitrofural was determined directly with the detective wavelength set at 375.0 nm.RESULTS: The linear ranges of salicylic acid and nitrofural were 10.77～43.08 ?g?mL-1(r=0.999 0) and 2.58～10.32 ?g?mL-1(r=1.000 0),respectively;and their average recovery rates were 99.55%(RSD=0.47%) and 100.03%(RSD=0.80%),respectively.CONCLUSION: The method is simple,rapid and accurate,and suitable for the quality control of Fu-La pastes.