MANF brakes TLR4 signaling by competitively binding S100A8 with S100A9 to regulate macrophage phenotypes in hepatic fibrosis

The mesencephalic astrocyte-derived neurotrophic factor (MANF) has been recently identified as a neurotrophic factor, but its role in hepatic fibrosis is unknown. Here, we found that MANF was upregulated in the fibrotic liver tissues of the patients with chronic liver diseases and of mice treated with CCl4. MANF deficiency in either hepatocytes or hepatic mono-macrophages, particularly in hepatic mono-macrophages, clearly exacerbated hepatic fibrosis. Myeloid-specific MANF knockout increased the population of hepatic Ly6Chigh macrophages and promoted HSCs activation. Furthermore, MANF-sufficient macrophages (from WT mice) transfusion ameliorated CCl4-induced hepatic fibrosis in myeloid cells-specific MANF knockout (MKO) mice. Mechanistically, MANF interacted with S100A8 to competitively block S100A8/A9 heterodimer formation and inhibited S100A8/A9-mediated TLR4-NF-κB signal activation. Pharmacologically, systemic administration of recombinant human MANF significantly alleviated CCl4-induced hepatic fibrosis in both WT and hepatocytes-specific MANF knockout (HKO) mice. This study reveals a mechanism by which MANF targets S100A8/A9-TLR4 as a "brake" on the upstream of NF-κB pathway, which exerts an impact on macrophage differentiation and shed light on hepatic fibrosis treatment.

Pharmaceutical care for a case of infective endocarditis caused by Micrococcus luteus complicated with severe pneumonia / 中国药房

OBJECTIVE To provide ideas and reference for the treatment and pharmaceutical care of infective endocarditis （IE） caused by Micrococcus luteus complicated with severe pneumonia. METHODS The clinical pharmacist participated in the treatment of a patient with IE caused by M. luteus complicated with severe pneumonia； all anti-infective treatment plans were agreed upon after the doctor invited the clinical pharmacist for consultation. After the implementation of the plan， the clinical pharmacist conducted pharmaceutical care of effectiveness and safety for the plan， including adopting suitable drug， adjusting the dose of vancomycin by using parameters such as steady-state valley concentration and creatinine clearance rate， monitoring renal function and adverse drug reactions. RESULTS IE caused by M. luteus was cured after surgery and full treatment with anti-bacterial drugs， the severe pneumonia was improved， and the decline of renal function caused by drugs and the primary disease were recovered； clinical pharmacists had ensured the effect of anti-infection treatment by assisting in the formulation of treatment plans and the implementation of pharmaceutical care， avoiding further renal damage and solving the problem of cefoperazone sulbactam- related drug fever. CONCLUSIONS IE caused by M. luteus is relatively serious， and the treatment drug can be vancomycin and rifampicin. During the treatment， it is necessary to monitor the renal function， and adjust the dose of vancomycin or change other drugs； anti-infection pharmaceutical care provided by clinical pharmacists can guarantee the effectiveness and safety of anti- infection plan， and avoid the occurrence of severe adverse drug reactions.

International and domestic researches about neurogenic bladder: a visualized analysis / 中国康复理论与实践

@#Objective To evaluate the development, hot spots and trends of the fields of neurogenic bladder.Methods The relevant articles of neurogenic bladder from January, 2000 to June, 2021 in CNKI and Web of Science were retrieved.The countries, authors, institutions, cited reference and keywords were extracted with CiteSpace to draw knowledge mapping. Results and Conclusion A total of 5 064 articles were enrolled. At present, the research on the field of neurogenic bladder is in a stable period of development, and this field has been widely concerned by scholars at home and abroad. The cooperation between domestic authors and institutions is not close enough compared with foreign countries, and domestic cooperation is more between medical schools and their respective affiliated hospitals. In the future, China can further strengthen cross-regional and cross-agency cooperation. Low-frequency electrical stimulation and sacral nerve regulation are seem to be research hotspots, and children's neurogenic bladder and robot-assisted technologies are also needed more attention.

Research progress of optimized mesenchymal stem cells on the treatment of end-stage liver diseases / 中华肝胆外科杂志

End-stage liver disease refers to the advanced stage of liver disease caused by various acute and chronic liver damage, of which decompensated cirrhosis and liver failure are most common. Currently, liver transplantation is the most effective treatment option for patients with end-stage liver disease, but several limitations regarding transplantation currently restrict its application. Mesenchymal stem cells are the potential treatment option for end-stage liver disease because of the biological properties such as multidirectional differentiation, paracrine and immunomodulatory properties, as well as anti-inflammatory, anti-apoptotic and anti-fibrosis, but the therapeutic effect is affected by low homing rate, poor colonization and low conversion rate. The researchers aimed to improve them through genetic modification, chemical or hypoxic pretreatment, and three dimensional culture. This article reviewed and discussed the pretreatment methods, their application status of treatment for end-stage liver disease and the existing problems.

Pharmaceutical care of voriconazole combined with micafungin in the treatment of aspergillus endocarditis / 中国药房

OBJECTIV E To provide ideas for diagnosis and treatment of fungal endocarditis. METHODS The diagnosis and treatment of 1 case of aspergillus endocarditis participated by clinical pharmacists were analyzed. Clinical pharmacists suggested that blood macrogenomic next-generation sequencing （mNGS）detection and blood microbial culture should be performed to assist in the diagnosis of fungal endocarditis ；considering the mechanism ，target and safety of the drug ，it was suggested to use voriconazole combined with micafungin for antifungal treatment ；through combining with the patient ’s condition and weighing up the pros and cons ，the dose of micafungin was adjusted to 300 mg per day ；clinical pharmacists prevented ，evaluated and dealt with adverse drug reactions during treatment ，and also provided medication guidance and long-term follow-up for the patient after discharge. RESULTS The clinician adopted the advice of the clinical pharmacists. Aspergillus fumigatus was detected in blood mNGS，which bought time for early diagnosis and individualized treatment of the patient. After 1 month treatment of voriconazole combined with micafungin ，the patient ’s condition was well controlled. The alkaline phosphatase and γ-glutamyl transferase of the patient returned to normal after treatment with adenosylmethionine succinate. With the help of medication guidance ，education and discharge follow-up of clinical pharmacists ，the medication compliance of the patient was good and the condition was stable. CONCLUSIONS The clinical pharmacists participate in the diagnosis and treatment process of the patient ，formulate an individualized anti-infective treatment plan for the patient and achieve good results ，which reflect the professional ability and service level of the clinical pharmacist ，and provide ideas for the clinical treatment of fungal endocarditis.

Laparoscopic modified Y-V plasty for recurrent bladder outlet obstruction induced by operation of benign prostatic hyperplasia / 中华泌尿外科杂志

Objective To investigate the clinical effect of laparoscopic modified bladder neck Y-V plasty in the treatment of recurrent bladder outlet obstruction after surgery for prostatic hyperplasia.Methods Seventeen patients with recurrent bladder outlet obstruction after prostatic hyperplasia operation from May 2017 to January 2019 was treated by laparoscopic bladder neck Y-V plasty,with the median age of 71 years old (65-81 years).All had a history of repeated urination obstruction and urinary tract infection,and experienced at least 2 times transurethral stenosis incision,resection or repeated urethral dilatation,with 12 cases of bladder neck stenosis (type Ⅰ) and 5 cases of middle prostate stenosis (type Ⅱ).Three-port laparoscopy surgery was performed with outer-peritoneal route into the Retzius Gap.After revealing the bladder and prostate junction,the "Y" incision of the bladder and stenosis of the prostate urethra was firstly performed,and inverted symmetrical "V" shape suture was performed with two 3-0 Stratifix suture for two layers,including the 1th layer suture of mucosal and inner muscle layer,and the 2nd layer suture of the outer muscle and the serous layer.F22 silicone catheter was indwelled for 2 weeks postoperatively.Urinary flow rate and bladder urethral examination were perfrmed to evaluate the effect of surgery 2 weeks and 3 months after the operation respectively.Results Seventeen operations were completed successfully,with the median operation time of 100 minutes (30-100 minutes),the median operation blood loss of 50 ml (20-100 ml),and the median hospital stay of 5 days (1-7 days).The patient had unobstructed voiding after removing the urinary catheter 2 weeks postoperatively,and had no urinary incontinence.Postoperative median follow-up was 7 months (3-17 months) and no stenosis of the urethra was detected.Conclusions Laparoscopic modified bladder neck Y-V Plasty has the advantages of high success rate,low recurrence rate and minimally invasiveness in the treatment of recurrent bladder outlet obstruction after prostatic hyperplasia surgery,which is worthy of clinical application.

Clinical study of transverse island fasciocutaneous fascia flap for treatment of meatus and navicular fossa stricture / 中华泌尿外科杂志

Objective To investigate the clinical effect of transverse island fasciocutaneous penile flap in the treatment of meatus and navicular fossa stricture.Methods Fifteen patients with urethral reconstruction with transverse island fasciocutaneous penile flap from October 2014 to December 2018 were enrolled.Six patients had a history of urethroscopic surgery,three had a history of lichensclerosus,three had a history of urethral dilation,and three had no obvious causes.All patients underwent transverse incision under the coronal sulcus,and after fully dissecting the urethra,the urethra was opened longitudinally ventrally.After measuring the actual length of stenosis,the irradiance fascia flap with the corresponding length of the incision was reconstructed.The patients were reviewed at 1 and 3 months after operation,and any complications such as recurrence or urinary fistula were recorded.The urine flow rate was tested 3 months after surgery.Results All 15 patients in this group underwent a successfully operation.The actual measurement of urethral stricture length was 0.5-4.0 cm during operation,with the average of 2.82 cm.Three months after the operation,the urine flow rate ranged from 13.5 ml/s to 23.7 ml/s,with an average of 18.5 ml/s.The overall successful rate was 93.3％ (14/15).The rate of post-operative fistula was 20.0％ (3/15).Two cases complained of needle-like fistula at the incision.One case healed after 3 months,and the other gave up further treatment.One patient developed urethral stricture and urethral skin spasm again 1 month later and was surgically repaired again.Conclusions The initial experience of pedicled island fascia flap for the treatment of urethral stenosis and scaphoid stenosis is safe,feasible and effective for the treatment of urethral stricture.

Analysis of the Alternate Application of Anticoagulant Drugs and Coagulant Drugs in the Patients with Thrombosis and Hemorrhage / 中国药师

A 72-year-old female patient was admitted to our hospital due to chronic cough, expectoration and dyspnea for 10 years,aggravated with intermittent fever for 1 month. She was diagnosed as acute exacerbation of chronic bronchitis,chronic pulmonary heart disease,cardiac function class IV,bilateral lower extremity venous thrombosis and thrombocytopenia. The application of antico-agulant drugs and coagulant drugs in the patient needed to be well weighed with the methods of the bleeding score system combined with clinical assessment of actual risk of bleeding. The interactions of drugs harmful to the patient should be considered and the prognosis of the patient should also be evaluated with careful clinical thought to reduce the patient's risk.

Salidroside-regulated Glucose Metabolism with Down-regulation of Micro RNA-370 in Type 2 Diabetic Mice / 医药导报

Objective To observe the effects of salidroside regulating glucose metabolism in type 2 diabetic mice,then to explore the molecular mechanism. Methods Type 2 diabetes model was induced by feeding high-fat diet and intraperitoneal injecting STZ to male C56BL/6J mice,then the glucose related indexes,micro RNA-370 levels in the serum and liver tissue and the expression of gluconeogenesis key protein(G6Pase and PEPCK) in the liver tissue to observe the treatment effects of salidro-side on type 2 diabetic-caused gluose metabolic disorder.In cell test,we isolated primary hepatocytes,then silenced or over-ex-pressed micro RNA-370 in mouse primary hepatocytes to observe the molecular mechanism of glucose metabolic regulation of the micro RNA-370 and salidroside. Results Treated with salidroside 40,80 and 160 mg·kg-1,the results showed that compared with the model control group,the glucose related indexes were all improved significantly.The relative expression levels of micro RNA-370 in serum and liver,and that of PEPCK and G6Pase all reduced in different degrees,dose-dependently.The changes of middle and high dose group decreased significantly(P<0.05),that of low dose group had a decreasing trend but no statistically significant.In the cell test,compared with the normal control group,salidroside alone group and micro RNA-370 inhibitor group were able to reduce the protein expression level of PEPCK and G6Pase(P<0.05),micro RNA-370mimic alone group can signifi-cantly increase the protein expression level of PEPCK and G6Pase(P<0.05),compared with the micro RNA-370mimic alone group,combining micro RNA-370 mimic and salidroside can significantly reverse the increasing caused by micro RNA-370 mimic alone(P<0.05). Conclusion Our research found that salidroside can improve glucose metabolism disorder in type 2 diabetic mice,and at least in part,through the suppression of micro RNA-370 expression for the first time.

Case study on a patient with hypothyroidism induced by amiodarone / 药学实践杂志

Objective To explore the methods and ideas of pharmaceutical care by analyzing a case of amiodarone induced hypothyroidism.Methods Through participating in the treatment for an atrial fibrillation case with hypothyroidism, the cause of hypothyroidism was analyzed by literature searching, patient′s clinical and medication history review and other related examinations.Results Clinical pharmacists proposed that the patient′s hypothyroidism was due to the long-term use of amiodarone.Conclusion Clinical pharmacists worked closely with physicians to provide rational medication treatment, improve therapeutic efficacy and reduce adverse drug reactions.

t-PA negatively regulating p75NRT for involving in atherosclerosis by changing reconstruction of vascular outer membrane autonomic nerve / 重庆医学

Objective To study the effect of tissue plasminogen activator (t-PA) on p57NTR ,inflammatory reaction ,immune regulation and oxidative stress and its effect on intimal hyperplasia .Methods The vascular injury treatment was performed in the diabetic rabbit model with carotid arterial adventitia stripping ,meanwhile t-PA controlled release microspheres were given ,the nerve distribution in the local blood vessels was observed by immunohistochemical staining .The change of nerve remodeling in the control group and treatment group was observed ,meanwhile the effect of giving t-PA controlled release microspheres on the release of ace-tylcholine and norepinephrine was detected .RT-PCR was used to detect local vascular tissue inflammation ,immune effects and oxi-dative stress .The sympathetic neurons and smooth muscle cell co-culture was adopted ,then giving glyoxal treatment as the athero-sclerosis cell model .With the t-PA treatment group as the intervention group ,the effect of t-PA on the number of cholinergic neu-ron ,and synaptic connections between the smooth muscle cells and acetylcholine secretion was observed .The change of t-PA-MMP-p75NTR and NF-kappa B signaling pathway were detected by RT-PCR .Results The vascular injury treatment was performed in the diabetic rabbit model with carotid arterial adventitia stripping ,meanwhile t-PA controlled release microspheres were given ,the nerve distribution in the local blood vessels was observed by immunohistochemical staining .The change of nerve remodeling in the control group and treatment group was observed ,meanwhile the effect of giving t-PA controlled release microspheres on the release of acetylcholine and norepinephrine was detected .RT-PCR was used to detect local vascular tissue inflammation ,immune effects and oxidative stress .The sympathetic neurons and smooth muscle cell co-culture was adopted ,then giving glyoxal treatment as the ath-erosclerosis cell model .With the t-PA treatment group as the intervention group ,the effect of t-PA on the number of cholinergic neuron ,and synaptic connections between the smooth muscle cells and acetylcholine secretion was observed .The change of t-PA-MMP-p75NTR and NF-kappa B signaling pathway were detected by RT-PCR .Conclusion t-PA activates MMPs and feedback in-hibits p75NTR-NF-kappa B signaling pathway to increase vascular adventitia autonomic nerve reconstruction and delay the occur-rence and development of atherosclerosis disease .

Mechanism of Salidroside on Regulating Disorder of Glucose and Lipid Metabolism of Primary Mouse Hepatocytes / 医药导报

Objective To observe the effects of salidroside on regulating glucose and lipid metabolism in high sugar high fat induced primary mouse hepatocytes,and to explore the molecular mechanism. Methods Primary hepatocytes were extracted from mice and cultured, then divided into normal control group, model control group ( high sugar high fat induced) ,and salidroside group(high sugar high fat induced and salidroside treated).Model control group and salidroside group were cultured in a high sugar and fatty medium with the optimal concentration of salidroside for 24 h. The glucose consumption, glycogen, and triglyceride concentration were detected, and key proteins of glucose and lipid metabolism were detected by RT-PCR in all three groups. Results Compared with model control group, the glucose consumption and glycogen concentration were both increased ( P<0. 05 ) in salidroside group ( P<0. 05 ) , triglyceride concentration were decreased ( P<0. 05 ) , the mRNA level of gluconeogenesis key protein ( G6Pase and PEPCK) and lipid synthesis key protein ( SREBP-1c, FAS-1, DGAT-2) mRNA expression level were increased (P<0.05),and the level of lipid oxidation key protein (CPT-1α) was decreased (P<0.05). Conclusion Salidroside can reduce insulin resistance and correct glucose and lipid metabolic disorder in high sugar high fat induced primary mouse hepatocytes.

Mechanism of Salidroside on Regulating Disorder of Glucose and Lipid Metabolism of Primary Mouse Hepatocytes / 医药导报

Objective To observe the effects of salidroside on regulating glucose and lipid metabolism in high sugar high fat induced primary mouse hepatocytes,and to explore the molecular mechanism. Methods Primary hepatocytes were extracted from mice and cultured, then divided into normal control group, model control group ( high sugar high fat induced) ,and salidroside group(high sugar high fat induced and salidroside treated).Model control group and salidroside group were cultured in a high sugar and fatty medium with the optimal concentration of salidroside for 24 h. The glucose consumption, glycogen, and triglyceride concentration were detected, and key proteins of glucose and lipid metabolism were detected by RT-PCR in all three groups. Results Compared with model control group, the glucose consumption and glycogen concentration were both increased ( P<0. 05 ) in salidroside group ( P<0. 05 ) , triglyceride concentration were decreased ( P<0. 05 ) , the mRNA level of gluconeogenesis key protein ( G6Pase and PEPCK) and lipid synthesis key protein ( SREBP-1c, FAS-1, DGAT-2) mRNA expression level were increased (P<0.05),and the level of lipid oxidation key protein (CPT-1α) was decreased (P<0.05). Conclusion Salidroside can reduce insulin resistance and correct glucose and lipid metabolic disorder in high sugar high fat induced primary mouse hepatocytes.

Practice of Medication Reconciliation among Chronic Renal Insufficiency Patients by Clinical Pharmacists / 中国药房

OBJCETIVE:To investigate the role of clinical pharmacists in medication reconciliation. METHODS:Totally 200 inpatients admitted or transferred to nephrology department of our hospital during Aug.-Oct. 2015 were selected. Within 48 h after admission,1-year medication history were collected by reviewing electronic medical records,consultation,querying self-prepared drugs and medical history;and then medication reconciliation was conducted by clinical pharmacists. RESULTS:Among drug lists collected by clinical pharmacists,there were 987 kinds of drugs,but only 9.63%(95 kinds) drugs were recorded in the medical records. There were 5 cases of ADR in total,and only 40.00% of them (2 cases) were recorded in the medical records. Among 200 patients,medication reconciliation was needed in 45 cases with reconciliation rate of 22.50%. Among 492 medical orders of 200 patients,medication errors were found in 103 medical orders;the number of medication errors per case was (2.3 ± 1.8), mainly including wrong dose,repeated medication,wrong solvent,drug interactions;the potential risk degree was mainly degree 1 (53 orders,51.46%). Among 103 medication reconciliation orders,main plans were drug withdrawal (78 cases,75.73%), followed by drug change(17 cases,16.50%)and drug supplement(8 cases,7.77%). A total of 90 reconciled medical orders were adopted by physicians,with success rate of 87.38%. CONCLUSIONS:Compared with physicians,clinical pharmacists can obtain more detailed and accurate drug list. It can reduce medication error and guarantee the safety of drug use to maximum extent that clinical pharmacists conduct medication reconciliation.

Comparative Study on the Application of Sofren Injection in Respiratory Department before and after Intervention / 中国药师

Objective: To compare the application of Sofren injection in respiratory department before and after the intervention to provide reference for clinical application and pharmacy management.Methods: A retrospective study was conducted on the medical records of inpatients treated with Sofren injection, and then intervene the found problems.Comparative study of Sofren injection in respiratory department before and after the intervention was performed.Results: Among the 584 cases in the retrospective study, those with off-indications were 438 ones (75%), those with inappropriate solvents were 555 ones (95.03%), and those with improper course were 196 ones (33.56%).After the intervention in the clinical practice, the improvement rate of improper solvents was 98.70%, that of off-indications was 29.85%, and that of unsuitable course was 77.71%.Conclusion: Through comparative study on the main problems before the intervention and the effective performance of specific solutions, the application of Sofren injection in respiratory department is greatly improved, which provides reference for the special management of other drugs.

Constructing tissue-engineered bladder by vascular endothelial growth factor nanoparticle-bacterial cellulose composite scaffold with various kinds of cells / 中国组织工程研究

BACKGROUND:Traditional bladder repair methods have many problems such as damage to normal organ function and many postoperative complications. Tissue engineering technology provides a new way for bladder repair. OBJECTIVE:To explore the feasibility of constructing tissue-engineered bladder with vascular endothelial growth factor (VEGF) nanoparticle-bacterial celulose (BC) composite scaffold with rabbit lingual epithelial cels andtonguemuscle cels. METHODS:Rabbit lingual epithelial cels andmuscle cels were successively implanted onto the BC scaffold (control group) and VEGF-BC scaffold (experimental group). Six rabbits were taken to make bladder defect models and randomized into two groups: experimental group implanted with VEGF-BC scaffold carrying autologous lingual epithelial cels andtonguemuscle cels,and control group implanted with BC scaffold carrying autologous lingual epithelial cels andtonguemuscle cels. Specimens were taken from the two groups for urographic evaluation and histological examination at 3 months after implantation. Meanwhile, the urodynamic tests were performed. RESULTS AND CONCLUSION:The experimental group showed the relatively complete bladder, and the control group showed a smal-area filing defect of the bladder. The maximum bladder capacity and bladder compliance in both two groups were decreased after implantation, especialy significantly in the control group (P< 0.05). In the control group, it failed to build a complete epithelial cel layer, and the muscle layer and microvessels were formed a little. In the experimental group, the complete epithelial cel layer was formed, and a larger amount of muscle layers and capilaries appeared. These findings indicate that the VEGF-BC scaffold carrying lingual epithelial cels andtonguemuscle cels can be used to construct thetissue-engineered bladder.

Design of acoustic radiation force module for ultrasound elastography / 中国医疗器械杂志

Developing an acoustic radiation force excitation module including 64 channels based in FPGA for ultrasound elastography. The circuit of the module was derived in bipolar, and the parameters such as excitation frequency, pulse repetition frequency, pulse number, element number and focus depth were adjustable. The acoustic field for special parameter was experimented with OptiSon laser acoustic field system with a result which reflects the width of focal spot is about 3 mm. The acoustic power was experimented with RFB2000 radiation force balance with a result which reflects acoustic power is increasing linearly with the number of pulses and the number of elements, and is increasing squarely with the peak-to-peak value of excitation voltage. The module is promising in factual application which can be triggered externally in synchronously, and can be combined with B-mode ultrasound system for ultrasound elastography.

Reinforcing the continent mechanism of continent cutaneous diversions by wrapped rectus abdominis muscle flap :an experimental study / 中华泌尿外科杂志

Objective To develop a new continent cutaneous diversion using a tapered ileum wrapped by rectus abdominis muscular flap. Methods Ten dogs underwent a procedure in which two 6 cm ileal segments were tapered and connected to the U-shaped reservoir which was detubularized by a 30-40 cm ileal segment with end-to-side anastomosis. A continent tube was created by a 6 cm length and 3 cm width rectus abdominis muscular flap with its blood supplied which was penetrated be-tween the mesenteric vessels of one tapered ileum (study tube) and wrapped around its periphery. The other tapered ileum (control tube) was brought out into the abdominal skin directly without any extra-mural support. Urodynamic studies were carried out at 1, 3 and 6 months postoperatively. The data of maximum inner pressure (MIP) and functional pressure length (FPL) of every study and control tubes at every study phase were recorded and statistics analysis were taken. Retrograde radiograms of the ef-ferent tubes were performed prior to sacrifice and histological examinations of study group were carried out after sacrificed. Results The average MIP in experimental group was significantly higher than that in control group at 1, 3 and 6 months post-operatively (P<0.01). However, no significant differences in MIP or FPL were found in study group between empty and full reservoir. In the control group, MIP was found rising significantly (P<0.001) and FPL (P<0.05) decreased sharply com-pared with empty and full reservoir. Retrograde radiograms confirmed that all efferent tubes were pa-tent and positioned straightly beneath the abdominal wall. Histological examination of study group at 6 months postoperatively demonstrated a layer of striated muscle around the serosa of the ileum. Conclusions The continent mechanism of tapered ileum could be enhanced by extramural support from wrapped rectus abdominis muscular flap. This technique could setup a reliable, easy catheterization continent cutaneous efferent tube.

Clinical evaluation of endoluminal catheter-bused ultrasonography in the upper urinary tract / 中华泌尿外科杂志

Objective To evaluate the feasibility and efficiency of endoluminal catheter-based ultrasonography on diagnosis of upper urinary tract diseases. Methods From January 1997 to December 2006,the clinical data of upper urinary tract of 68 cases who examined by endoluminal uhrasonography with a 10 MHz miniature ultrasound transducer and a 8 F outer catheter were reviewed.There were 30 males and 38 females aged 17-81 years with an average of 58 years.The renal pelvis and its surrounding structures were examined in 48 cases and the ureter and its surrounding structures were examined in 20 cases.The total of 73 sides had experienced by this technique.The accuracy of diagnosis with endoluminal catheter-based ultrasonography was evaluated by the pathology and clinical follow-up. Results The total success rate of the ultrasound probe introduced into ureter was 91%in 68 cases.In the pelvis group it was 96%(46/48)and the ureter group 80%(16/20).In renal pelvis abnomalities,the detectable rate of abnormal by ultrasonography was 89%(41/46).The total detectable rate in ultrasound probe group was significantly higher than that in other equipment groups(P＜0.01).The detectable rate of ultrasonography on ureter disease was 75%(12/16). Conclusion Endoluminal catheter-based ultrasonography is an effective,safe technique for the diagnosis of diseases in the upper urinary tract.

Urethral reconstruction with colonic mucosa in treatment of complex urethral stricture / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the possibility of urethral reconstruction with colonic mucosa for the treatment of complex longer urethral stricture (>/= 10 cm).</p><p><b>METHODS</b>From October 2000 to September 2001, 6 patients with complex longer urethral stricture were treated with colonic mucosal graft urethroplasty. They had under gone 3 previous unsuccessful urethral repairs on average. Urethral reconstruction with a free graft of colonic mucosa ranged from 10 to 15 cm (mean 12.17 cm). Follow-up included retrograde urethrography, urethroscopy, and uroflowmetry.</p><p><b>RESULTS</b>The patients were followed up 3 - 14 months postoperatively (mean 7.8 months). Meatal stenosis developed in one patient 3 months after operation needed reoperation. The patient voided very well with urinary peak flow 28.7 ml per second duing follow-up for 12 months postoperatively. The other patients voided well with urinary peak flow greater than 15 ml per second. At urethroscopy, colonic mucosa was macroscopically difficult to distinguish from normal original urethral mucosa in 4 patients over 6 months after the operation.</p><p><b>CONCLUSIONS</b>Colonic mucosa graft urethroplasty is feasible for the treatment of complex longer anterior urethral stricture. The technique is useful for urethral reconstruction when penial skin and bladder mucosa are not available.</p>