Progress in prevention and treatment of enterovirus 71 infection / 中华微生物学和免疫学杂志

Enterovirus 71 (EV71) is a major pathogen causing severe hand, foot and mouth disease (HFMD) in infants under five years old. It can cause central nervous system damageand even death in severe cases. Considering the high mortality and disability rate of HFMD, this review focused on the most recent developments in vaccines and treatments against EV71 infection.

Changes and clinical significance of inflammatory indices in patients with urogenic sepsis with different severity / 中华创伤杂志

Objective:To explore the changes and clinical significance of inflammatory indices of urogenic sepsis with different severity.Methods:A retrospective case-control study was used to analyze the clinical data of 71 patients with urogenic sepsis admitted to 940th Hospital of PLA Joint Logistics Support Force from January 2010 to April 2018, including 34 males and 37 females, aged 39-96 years [(63.1±18.3)years]. The patients were divided into three groups according to the clinical diagnostic criteria for septic shock and sepsis according to the 2014 edition of the Chinese Urology Surgical Guidelines for Diagnosis and Treatment: 21 cases in sepsis group [sequential organ failure assessment (SOFA) score of 3.0 (2.0, 3.0)points], 21 cases in severe sepsis group [SOFA score of 9.0 (6.0, 11.0)points], and 29 cases in septic shock group [SOFA score of 15.0 (14.0, 16.0)points]. Spearman correlation analysis was used to analyze the correlation of inflammatory indicators with SOFA, including white blood cell count, percentage of neutrophils, C-reactive protein, interleukin-6, procalcitonin, fibrinogen, D-dimer, and platelet. Multiple linear regression analysis and stepwise regression weighted analysis were performed to analyze the relation between inflammatory indicators and sepsis severity. Levels of each inflammatory indicator was detected and compared among the groups.Results:① Spearman correlation analysis: percentage of neutrophils, D-dimer, interleukin-6, procalcitonin and SOFA scores were significantly positively correlated, with the r s value of 0.738, 0.712, 0.31, 0.795, respectively ( P<0.01); platelet and SOFA scores were significantly negatively correlated, with the r s value of -0.661 ( P<0.01). ② Multiple linear regression analysis: percentage of neutrophils, platelet, D-dimer, procalcitonin and SOFA score were significantly correlated ( P<0.01); Stepwise regression weighted analysis suggested that the model linear relationship and fit was good. ③ Inflammatory index comparison: percentage of neutrophils in sepsis group, severe sepsis group and septic shock group was 82.30 (76.25, 88.45), 90.50 (86.55, 93.85), 95.10 (92.05, 97.95), respectively; level of platelet was 183.01 (144.50, 246.50)×10 9/L, 149.11 (81.04, 207.00)×10 9/L, 81.26 (50.01, 93.50)×10 9/L, respectively; level of D-dimer was 0.98 (0.71, 1.74)mg/L, 3.45 (1.79, 5.56)mg/L, 7.19 (4.26, 11.63)mg/L, respectively; level of procalcitonin was 0.55 (0.21, 1.09)ng/ml, 5.45 (3.74, 11.80)ng/ml, 17.68 (13.97, 26.75)ng/ml, respectively. There were significant differences in above indicators among the groups ( P<0.05). Conclusions:The serum levels of procalcitonin, percentage of neutrophils, D-dimer and platelet are positively correlated with the severity of urogenic sepsis. While combined detection of those indicators can better predict the severity of the sepsis.

Association of inflammatory indices with the severity of urinary sepsis: analysis of 70 cases / 南方医科大学学报

OBJECTIVE@#To analyze the association of the clinical inflammatory indices with the severity of urinary sepsis.@*METHODS@#We reviewed the clinical data of 70 patients with urinary sepsis treated in our hospital between January, 2013 and April, 2018. All the patients were diagnosed in line with the Guidelines for Diagnosis and Treatment of Urological Diseases in China (2014 edition), including 22 patients with sepsis, 12 with hypotension and severe sepsis, 17 with septic shock, and 19 with critical septic shock. White blood cell count (WBC), neutrophil percentage (N%), platelets (PLT), fibrinogen (FIB), Ddimer, interleukin-6 (IL-6), procalcitonin (PCT) and C-reactive protein (CRP) were examined in all the cases and compared among the 4 groups. The correlations of these inflammatory markers with the severity of sepsis were analyzed using logistic regression analysis.@*RESULTS@#The 4 groups of patients showed significant differences in N%, PLT, D-dimer, and PCT ( < 0.05) but not in CRP (>0.05). Kruskal-Wallis Pairwise comparisons showed that the N% and PCT in patients with sepsis differed significantly from those in the other 3 groups; platelets in patients with sepsis differed significantly from those in patients with septic shock and critical septic shock; D-dimer differed significantly between patients with sepsis and those with septic shock. Among the 4 groups, the median levels of PLT decreased and PCT and N% increased with the worsening of sepsis. Logistic regression analysis indicated that PCT (=0.186, =0.000), N% (=0.047, =0.035) and PLT (=-0.012, =0.003) were significantly correlated with the severity of sepsis in these patients.@*CONCLUSIONS@#PCT, PLT and N% are all significantly correlated with the severity of sepsis, and their combined detection can be informative for assessing the severity of sepsis to facilitate clinical decisions on treatment.

Effects of information motivation behavior model on self-management behavior and self perceived burden of elderly patients with permanent bladder fistula / 现代临床护理

Objective To explore the effect of information-motivation-behavioral (IMB) skills model on self-management behavior and self perceived burden of elderly patients with permanent bladder fistula. Methods A total of 92 elderly patients with permanent urinary bladder fistula were randomly divided into experiment group and control group in our hospital from November 2015 to November 2016, 46 cases in each group. In the control group, taking classes, face-to-face education were done for a total of 6 months once a month, 60 minutes each time. In the experiment group, the IMB model was used for the nursing intervention for a total of 6 months once a month, 60 minutes each time. The two groups of patients were assessed by self management behavior scale and self perceived burden scale. Results After the intervention, the score on self-management ability of the experiment group was (76.32 ± 4.73), higher than (67.22 ± 3.14) of the control group (P<0.05). The score on the self perceived burden of the experiment group was significantly lower than that of the control group (10.32 ± 4.48 vs. 19.98± 6.63, P<0.05). Conclusion The implementation of IMB model can improve the self-management behavior of elderly male patients with bladder fistula, and reduce the burden of self perception.

Incidence and risk factors of urinary tract infection after ureteroscopy / 中国感染控制杂志

Objective To evaluate the incidence and risk factors of urinary tract infection(UTI)following uret-eroscopy.Methods Patients undergoing ureteroscopy examination or ureteroscopic lithotripsy in a hospital between 2002 and 2011 were analyzed retrospectively,clinical data of patients were collected and analyzed,including age, sex,history,complication ,urine routine test,urine culture,blood routine test,urethral catheterization,ureteral stent placing and antimicrobial use.Results Incidence of UTI following ureteroscopy was 3.77% (20/531),UTI fol-lowing ureteroscopy examination was higher than ureteroscopic lithotripsy (5.84% [9/154]vs 2.92% [11/377]). Pyelonephritis was the main infection type(n= 15 ),the main pathogen was Escherichia coli (n= 6 ),there was no statistical difference in UTI among patients receiving different types of antimicrobial prophylaxis (P= 0.185 ). Patients with bacteriuria,hydronephrosis,urethral catheterization,without ureteral stent placing,and without re-ceiving antimicrobial prophylaxis had higher incidence of URI(all P<0.05).Conclusion Bacteriuria,hydronephro-sis,urethral catheterization,without postoperative ureteral stent placing,ureteroscopy examination,and without receiving antimicrobial prophylaxis are risk factors of UTI following ureteroscopy.

Diagnosis and treatment of 30 cases of high altitude sickness combined with urinary retention / 中华泌尿外科杂志

Objective To explore the diagnosis and treatment of altitude sickness combined with urinary retention. Methods 30 cases of altitude sickness combined with urinary retention were treated from April 16th to 26th,2010.They were all male,The average age of them was 24 years (range,19 -38).All were the first time entering the high altitude area (3600 -5000 m) from low altitude area (600 - 1800 m ).The urinary frequency of 25 patients reduced from 8 to 10 times/d to 2 to 4 times/d,the urine output reduced from the 1500- 2400 ml/d to 600- 800 ml/d; the other 5 patients had no urine in 12 -18 h,even had no sense to urinate.26 patients also combined with altitude pulmonary edema and 4 combined with altitude cerebral edema.30 patients had double renal columns enlarged,21 cases had urinary protein ( + ～ ++ ). Results 30 patients were exported urine 300 -600 ml within 10 min,leaded to urine 1800 -2300ml in 12 h,returned to normal voiding after catheter removal in 18 -24 h. After comprehensive treatment such as oxygen,dehydration,diuretic,sedative,antispasmodic and anti-infection,22 cases who with chest tightness,shortness of breath,dyspnea,hemoptysis foam sputum,headache,vomiting and other symptoms of jet-like improved apparently after hospital admission within 1 hour.Their heart rate downed from 90 - 145beats/min to 68 -92 beats/min,respiration from 28 -45 times/min to 18 - 28 times/min,oxygen saturation from 48％ - 84％ to 92％ - 100％ ; 8 cases who with shortness of breath,palpitation and headache improved not obviously.After the antihypertensive treatment,their blood pressure was still high (systolic blood pressure 150 - 180 mm Hg,diastolic blood pressure 90 -110 mm Hg),oxygen saturation between 78％ to 87％,so they were carried to rear area for further treatment.30 cases were all cured no death. Conclusions The high altitude urinary retention is reversible disease,which is often associated with high altitude pulmonary edema,altitude cerebral edema,acute subclinical renal dysfunction and gastrointestinal disorders.They are easily being induced by elements such as gastroenteritis,lung infection,tonsillitis,periodontitis,tiredness and so on; low atmospheric pressure,hypoxia and high altitude is the possible cause; the ratio of missed diagnosis is high; the treatment of oxygen and indwelling catheterization is better; The best method of prevention is to wear pressurized suits and adapt the environment in a ladder-step gradual way.

Diagnosis and pathogens distribution in 14 cases with severe pulmonary infection following kidney transplantation / 中国组织工程研究

OBJECTIVE: Strengthen realization of pulmonary infection and perform follow-up plays a key role in preventing severe pulmonary infection following kidney transplantation. The aim of this study is to analyze the diagnosis and pathogens distribution in patients with pulmonary infection following kidney transplantation. METHODS: Totally 14 patients with severe pulmonary infection following kidney transplantation, who received treatment at The Department of Urology Center, Lanzhou General Hospital of Lanzhou Military Area Command of Chinese PLA, from May 2004 to September 2008, were analyzed. Including 10 males and 4 females, aged from 20 to 65 (37.3±11.4) years. Six patients suffered pulmonary infection within 3 months, 7 patients occurred pulmonary infection occurred during 3-6 months, and pulmonary infection occurred in 1 patient at 6 months after kidney transplantation. The infection rate was 93% during 6 months after kidney transplantation. The diagnosis of pulmonary infection was according to the clinical manifestation of respiratory system, and combined with specificity display of sternum, CT or detection of pathogen. Oxygen inhale and mechanical ventilation were employed for admitted patients. And electrolytes, acid-base equilibrium was daily detected. Twelve patients accepted "three-medicine" treatment and 2 cases accepted "four-medicine" treatment. The therapeutic drugs could be regulated individually. The dose of immunosuppressive agent was adjusted due to ciclosporin, CD4~+/CD8~+, and C-reactive protein levels. RESULTS: The pathogens of pulmonary infection were bacteria (5 patients), fungi (4 patients), and mixed infection (3 patients). No pathogen was found in 2 patients. Four patients died of acute respiratory distress syndrome, 1 patient died for quitting treatment. The remained 9 patients were cured. The mortality was 36%, and the recovery rate was 64%, CONCLUSION: The cure rate of patients with severe pulmonary infection following kidney transplantation can be increased by early combining antibiotics treatment, regulating immunosuppressive agents, early identifying pathogens, taking respiratory support therapy, as weii as adding nutritional supplement.

In vitro reconstruction of malformed renal blood vessels prior to kidney transplantation: 2 years follow-up / 中国组织工程研究

OBJECTIVE: Anatomic variation of renal artery existed in donor kidney, and whether the variation would affect clinical effects is unconfirmed. This paper is aimed to study the outcomes of in vitro reconstruction of malformed renal blood vessels on outcome of kidney transplantation. METHODS: Patients treated with kidney transplantation at Department of Urology, Lanzhou General Hospital of Chinese PLA were selected; including 27 cases underwent kidney transplantation with malformed blood vessels. Seventeen of them had accessory renal artery, 10 of them with two or three renal arteries. Additional 22 patients transplanted with normal kidney during the same period were selected as the control group. Bench surgery with microsurgical techniques was employed for the repair of the vessels, which included 11 cases of end to end anastomosis of arteries, 6 cases of end to side anastomosis of arteries, 6 cases of side to side conjoined anastomosis of arteries, and 4 cases of renal artery lengthening with an interposition of donor or recipient iliac artery. The hemorrhage, hypertension, renal arterial stenosis, delayed graft function, incidence rate of acute rejection, and the serum creatinine level were followed up.RESULTS: Totally 49 cases were received a mean 2-year follow-up, and no death occurred in both groups. Two cases in the experimental group, and 3 cases in the control group were suffered hypertension or hypertension aggravated, the difference had no significant (P =0.673). No arterial stenosis occurred during the follow up. In the experimental and control groups, the incidence of delayed graft function was 20% and 14%, the incidence of acute rejection was 13% and 5%, and mean serum creatinine at 2 year was (119±11) and (127±8) μmol/L, respectively, the difference was not significant between two groups (P=0.179, 0.385, 0.658).CONCLUSION: Donor kidneys with malformed vascular can be used for transplantation after bench reconstruction, which do not influence the outcome of kidney transplantation.

Development of multi-function hydraulic pressure diagnostic and therapeutic instrument / 医疗卫生装备

This paper introduces some information of the multi-function hydraulic pressure diagnostic and therapeutic instrument, which is applied to the diagnoses and treatments of oviduct, matrix, urethra, bladder and bile duct, including its system function, operation principle, software and hardware designs. Being reliable, cheap, convenient and multipurpose, the instrument has a bright future in the market.

Expression of CD44v6 and E-cadherin in Human Renal Cell Carcinoma and Their Significance / 中国医师杂志

Objective To study the expression and significance of CD44v6 and E-Cadherin( E-cd) in human renal cell carcinoma. Methods Immunohistochemical method was used to detect CD44v6 and E-cd expression in 20 normal renal tissues and 72 primary renal cell carcinoma tissues. Results The postive expression rate of CD44v6 in normal renal tissues and primary renal cell carcinoma tissues was 15 00% and 66 67% respectively with significant difference (P

Effects of angiostatin gene transfection on biological behaviors of bladder carcinoma BIU-87 cell line / 解放军医学杂志

Objective To explore the expression and effects of extragenous angiostatin gene in human bladder carcinoma BIU-87 cell line. Methods A full human angiostatin gene was cloned into expression vector pcDNA3.1(+) and transfected into human bladder carcinoma BIU-87 cells by lipofectamine, and the positive clone was screened by G418. The growth characteristics of BIU-87 cells before and after transfection were compared.The expressions of angiostatin protein in BIU-87 cells were examined by immunofluorescence assay, immunohistochemistry and Western blotting, and the activities of angiostatin protein were examined by endothelial cell inhibition assay and the chicken-embryo chorioallantoic membrane assay. Results The expression of extragenous angiostatin gene had no inhibitory effect on the growth of BIU-87. The transfected cells could inhibit the umbilical vein endothelial cell growth in vitro and chicken-embryo choriallantoic membrane angiogenesis in vivo. Conclusion The results indicated that the angiostatin gene clones could be transfected into BIU-87 bladder cancer cells, and angiostatin could inhibit endothelial cell proliferation and neovascularization.