First-line treatment of castration-resistant prostate cancer with enzaluamine / 中华泌尿外科杂志

This case was a 75-year-old prostate cancer patient with multiple cardiovascular diseases. The clinical stage was T 3bN 1M 0.After regular follow-up with androgen deprivation therapy (ADT)(Goserelin+ bicalutamide), the PSA increased slowly at the 13th month, and at the 17th month, the trend of progression to castrated resistant prostate cancer (CRPC) was considered, combined with patients with a variety of cardiovascular diseases, we choose the first-line application of Enzaluamine treatment, the disease has been effectively controlled. Through the diagnosis and treatment of this case, we should consider not only the effectiveness and safety of the treatment, but also the influence and risk of the treatment to the cardiovascular disease.

The retrospective study of oxacillin susceptible, mecA positive Staphylococcus aureus in China / 中华检验医学杂志

Objective The purpose of the study is to understand the epidemiology,distribution and molecular characteristics of oxacillin susceptible mecA positive Staphylococcus aureus (S.aureus).Methods Totally 1588 S.aureus isolates collected from 12 hospitals in 10 cities of China between 2010 and 2012 were retrospectively characterized.The isolates were characterized by antimicrobial susceptibility test of 20antimicrobial drugs.Three different methods (cefoxitin disc diffusion,agar dilution for oxacillin and cefoxitin) to detect oxacillin susceptible and mecA positive S.aureus were also compared.All the strains were confirmed to be S.aureus by detecting S.aureus specific genes by PCR (including nuc,femB,and mecA gene),which was viewed as the golden standard of MRSA.The molecular typing methods included SCCmec and spa typing.The statistical analyses were carried out in statistical product and service solutions (SPSS),Version 18.0.The significance level P was set at 0.05.Results According to the MICs of cefoxitin and oxacillin,a total of 60 isolates were oxacillin susceptible methicilin resistance Staphylococcus aureus (MRSA).Based on the differences of the specimen collection date,it is found that oxacillin susceptible MRSA have increased from 2010 to 2012 (P =0.05,95％ CI 0.045-0.056,X2 =6.099).These isolates were distributed in 9 major cities,and the highest prevalence is 30.0％ (18/60) in Guangzhou,followed by Beijing (18.3％,11/60),Wuhan (15.0％,9/60),Hangzhou (13.3％,8/60).Most of the isolates were from skin soft tissue infection (35％,21/60),blood stream infection (30％,18/60) and respiratory infection specimens (18.3％,11/60).The resistance rate to cefoxitin,erythromycin,clindamycin and tetracycline was 100％ (60/60),86.7％ (52/60),66.7％ (40/60) and 50％ (30/60),respectively.The molecular characterization showed that 21 spa and 5 SCCmec types were detected.The most predominant clone was spa t437-SCCmec Ⅳ (25.0％,15/60),followed by spa t437-SCCmecV (13.3％,8/60).Conclusions The detection rate of oxacillin susceptible MRSA is significantly higher from 2010 to 2012.The major clone is t437-SCCmec Ⅳ.The use of cefoxitin should replace oxacillin in detecting this type of MRSA.Further study is needed to confirm whether beta lactam antimicrobial agents should be used in the treatment of oxacillin susceptible mecA positive S.aureus.

Molecular characterization of St ap hy lococcus aureus in Yanbian / 中国感染与化疗杂志

Objective To investigate the molecular epidemiology of Staphylococcus aureus in Yanbian area .Methods From March 2011 to June 2012 ,a total of 101 consecutive and non-duplicate strains of Staphylococcus aureus were collected from Yanbian Hospital .Genotypes of SCCmec ,spa,and multilocus sequence typing (MLST) were determined by PCR combined with DNA sequencing analysis .The pvl gene was detected by PCR .Results The most prevalent SCCmec type was type II (65 .0% ,39/60) ,followed by SCCmec type III (26 .7% ,16/60) .A total of 11 Spa types were identified for the MRSA strains ,including t2460 (55 .0% ,33/60) ,t030 (18 .3% ,11/60) ,t002 ,t324 ,and t632 (5 .0% ,3/60 each) .A total of 29 Spa types were identified for MSSA strains ,including t796 (14 .6% ,6/41) ,t309 (9 .8% ,4/41) ,and t126 (7 .3% ,3/41) . The pvl gene was identified in 5 stains .MRSA strains were classified into three types based on multilocus sequence typing (MLST) ,namely ST5 ,ST239 and ST72 .MLST-based MSSA types were more diverse ,including ST5 ,ST 25 ,ST 15 ,ST 59 ,ST 1 ,ST 7 ,ST 45 ,ST 22 ,and ST 188 .Conclusions ST5-MRSA-SCCmecII-t2460 and ST239-MRSA-SCCmecIII-t030 are the most prevalent MRSA clones in Yanbian area .Multiple prevalent MSSA clones are identified.

Urinary calculi composition analysis and individualized prevention instruction / 中国实用护理杂志

Objective To investigate the calculi composition of patients with urinary calculi in Henan area and the clinical significance of preventing calculi recurrence with individualized method.Methods From August 2009 to July 2010,1050 patients in our hospital underwent extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy and percutaneous nephrolithotomy were set as the experimental group,all stone specimens were detected with the BRUKER TENSOR27 infrared spectroscopy for analysis of stone composition,and nurse on duty gave instructions according to the stone composition to prevent recurrence.From July 2008 to July 2009 1010 patients in our hospital underwent extracorporeal shock wave lithotripsy,ureteroscope and percutaneous nephrolithotomy were set as the control group,patients in the control group were not given calculi component analysis and these patients received general prevention guidance.The calculi recurrence was compared between two groups.Results Among 1050 cases in the experimental group,urinary calculi with single component accounted for 46.29％,of which calcium oxalate stones accounted for 44.95％.Calculi with mixed components accounted for 53.71％,mainly were calcium oxalate and carbonate apatite mixture components (30.48％).57 cases (5.43％) occurred urinary stone recurrence in the experimental group,while 177 cases(17.52％) in the control group.The difference had statistical significance.Conclusions Urinary calculi analysis has important clinical significance for understanding the causes and treatment of calculi as well as prevention of recurrence of calculi.

Transurethral Nephroscopic Pneumatic Lithotripsy Combined with Ultrasound Lithotripsy for Bladder Calculus / 中国微创外科杂志

Objective To explore the efficacy of transurethral nephroscopic pneumatic lithotripsy combined with ultrasound lithotripsy for bladder calculus.MethodsBy using transurethral F20.8 nephroscope and EMS LithoCaster,we performed transurethral nephroscopic pneumatic lithotripsy and ultrasound lithotripsy on 69 patients with bladder calculus(63 men and 6 women)between October 2005 and May 2008.The diameter of the calculi was ranged from 1.5 to 6.0 cm.Among the patients,42 had one stone in the bladder,while 27 had multiple calculi.Fifty-five patients were complicated with BPH,14 had neurogenic bladder,and 4 showed bladder diverticulum with stones in situ.Pneumatic frequency was set at 8-12 Hz,and ultrasonic energy was 50%-60%.For the patients with BPH electrovaporization ablation was plused.ResultsAmong the 69 patients,68 were cured in one session.The mean operation time was 25 minutes(15 to 40 minutes).One patient was converted to open surgery because of rupture of the bladder during the procedure.No patient had urethral stricture,infection,or massive hemorrhage during the operation.Follow-up was available in 68 patients for 6 to 10 months(mean,9 months).During the period,no recurrent calculi was found by ultrasonography and X-ray.ConclusionTransurethral nephroscopic pneumatic lithotripsy combined with ultrasound lithotripsy is effective for bladder calculus.