Effect of habit reversal training on the quality of life of patients with senile pruritus / 中国实用护理杂志

Objective To explore the effect of habit reversal training (HRT) on the quality of life of patients with senile pruritus (SP) Methods A total of 60 patients with SP were selected from the dermatology department of the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine.Using random number table method,the patients were divided into two groups,namely 30 patients in each group.Two groups of patients were treated with antihistamines and anticnesmatic.On this basis,the control group given health guide by holding group health lecture,once a week,about 60min each time,for eight consecutive times.The experimental group adopted the HRT on the basis of the control group,1 times per week in the first 4 weeks,and once every 2 weeks in the 5th to 12th week,and 30-60 min each time.Before the intervention and 4 weeks,8 weeks and 12 weeks after intervention,the Negative Emotion Scale and the Pittsburgh Sleep Quality Index(PSQI) were respectively used to evaluate the negative emotion and the sleep quality.Before the intervention and 12 weeks after intervention,the Structured Pruritus Symptom(SPS) and Dermatology Life Quality Index(DLQI) were respectively used to evaluate the pruritus symptom and the life quality of the patients with SP.Results The scores of Negative Emotion Scale and PSQI in the experimental group at the fourth,eighth and 12th weekends after intervention were lower than those in the control group at the same time,and the difference was statistically significant (the negative emotion:t=0.131,-6.072,-6.884;PSQI:t=-3.972,-5.173,-8.246,P ＜ 0.01).And the scores of two scales in the two groups were statistically significant in the inter-group effect,time effect and interaction effect.(The score of the Negative Emotion Scale:Ftime=96.635,Finter-group=10.329,Finteraction=5.371;the total score of PSQI:Ftime=5.371,Finter-group=368.063,Finteraction=19.910,P ＜ 0.05).Meanwhile,the total score of the SPS and the DLQI in the experimental group were lower than the control group after 12 weeks of intervention (Z =-3.267,t =8.283,P ＜ 0.01).Among them,there was no statistically significant difference in daily living items of DLQI (t =1.873,P＞0.05).Also,after intervention,the total score of the Negative Emotion Scale,PSQI and each item of PSQI in the experimental group at each time point were lower than previous point (P ＜ 0.05).The total score of the SPS,DLQI and each item of DLQI in the experimental group were lower than pre-intervention (Z =-4.610,t=15.850,P ＜ 0.01).Conclusions HRT could effectively relieve itching symptoms of patients with SP,improve the negative emotion and the sleep quality.It is worthy of further clinical promotion,thus effectively improve the quality of life of the patients with SP.

The efficacy and safety of intradetrusor injection of botulinum toxin type A in treatment of ketamine-related cystitis / 中华泌尿外科杂志

Objective To evaluate the efficacy and safety of intradetrusor injection of botulinum toxin type A in the treatment of ketamine-related cystitis.Methods A retrospective analysis of clinical data of 36 ketamine-related cystitis patients with intradetrusor injection of botulinum toxin type A treatment in our hospital during August 2010 to December 2015 was conducted, including 31 males and 5 females with a mean age of 25.5 years.All patients had failed to conventional treatment options including cessation of ketamine, antibiotics, M-blockers.At the time of the first injection, patients were injected with 200 U botulinum toxin type A diluted in 15 ml of 0.9％ saline into the detrusor muscle at 30 sites, sparing the trigone, under cystoscopic guidance.3-d voiding diary, interstitial cystitis symptom index (ICSI),interstitial cystitis problem index (ICPI), pelvic pain and urinary frequency/urgency symptom score (PUF) were recorded to evaluate the efficacy.The treatment-related complications were recorded.When the efficacy of botulinum toxin type A decreased and the patient's symptoms returned to baseline before treatment, the patient received repeated injections of botulinum toxin type A with the same dose and method as the first injection.Results Thirty-six patients with ketamine-related cystitis were treated with intradetrusor injection of botulinum toxin type A.Sixteen patients received two injection treatments and two patients received three injection treatments.During the follow-up, 3-d urinary diaries, ICSI, ICPI, and PUF showed a significant improvement in outcome at 4 weeks after the first injection.The efficacy of the second and third injection treatment was also remarkable.Three patients developed urinary tract infection after the first injection, and two patients developed urinary tract infection after the second injection.Mild hematuria occurred in 15 patients after the first injection, and mild hematuria occurred in 7 patients after the second injection, which was improved in 1 to 2 days.All patients did not appear acute urinary retention and other adverse drug reactions.Conclusions Intradetrusor injection of botulinum toxin type A could be a safe and effective method for the treatment of ketamine-related cystitis.Repeated injection therapy is still safe and effective.

Primary experience of intraperitoneal laparoscopic partial nephrectomy with zero ischemia time / 实用医学杂志

Objective To evaluate the feasibility and clinical efficacy of intraperitoneal laparoscopic partial nephrectomy for T1a peripheral renal neoplasms. Methods Intraperitoneal laparoscopic partial nephrectomy was performed without renal artery occlusion for T1a peripheral peripheral renal neoplasms. The operative time, bleeding volume and complications were observed and the clinical experience was summarized. Results From October 2014 to January 2017 ,there were 10 patients:7 males and 3 females. All patients had T1a peripheral renal tumors. 10 patients underwent operation successfully ,of which 1 case developed temporarily blocked renal artery in the surgery due to hemorrhage. There was no referral during surgeries. The operative duration was 108 to 210 min,with a median of 135 min. The estimated blood loss was 100 to 750 mL,with a median of 320 mL. Followed up duration was 2 to 24 months (median 12 months),there were not postoperative renal secondary bleeding , leakage and other complications. No recurrence of tumor was found. Conclusion It is feasible and safe to exercise intraperitoneal laparoscopic partial nephrectomy without renal artery occlusion in the treatment of T 1a peripheral renal tumors,which can protect renal function to the greatest extent.

Development of a clinical nomogram for predicting bladder outlet obstruction in male LUTS/BPH / 实用医学杂志

Objective To develop a clinical nomogram for predicting the probability of bladder outlet obstruction (BOO) in male LUTS/BPH using the most common and noninvasive parameters in clinical practice , with the hope of detecting BOO individually and precisely. Methods Retrospectively analyze the outpatients and inpatients of male LUTS/BPH from November 2003 to November 2015 in Guangzhou First People′s Hospital. Collect the Pressure-flow study parameters and other clinical parameters including Qmax , PV, TZV, TZI, PSA, and PVR. Find out the best independent predictors on the diagnosis of BOO and develop the nomogram for pre-dicting BOO. Results The data from 1 599 patients were analyzed. The areas under the ROC curve (AUCs)of PV, TZV, TZI, PSA, Qmax, and PVR were 0.803, 0.807, 0.698, 0.775, 0.742, and 0.641, respectively. Qmax, PV, and PSA were selected as the best clinical parameters to predict BOO. The Logistic regression equa-tion is Log(p)=0.332 4 - 0.201 8*Qmax + 0.026 6*PV + 1.135 1*PSA. Finally, a nomogram model was developed by R statistical software. This nomogram showed a concordance index of 0.854 according to the inter-nal validation of the model. Conclusions The clinical nomogram presented a high accuracy (85.4%) in de-tecting BOO, which would help predicting BOO in male LUTS/BPH noninvasively, individually, accurately, and providing valuable reference and guidance in clinical decision.

Therapeutic effect of antibiotic conjugated with 11 poly-arginine peptide on rabbit model with bacterial cystitis / 实用医学杂志

Objective To investigate the therapeutic effect of ciprofloxacin (Cipro) conjugated with 11 poly-arginine peptide (R11) on rabbit model with bacterial cystitis (BC). Methods 50 New Zealand rabbits of 4-month old were chosen to establish the models and evenly divided into 5 groups randomly : Group A: normal control; Group B: intravesical instillation (II) of R11; Group C: II of Cipro; Group D: II of R11-Cipro; Group E: intravenous injection of Cipro. Several parameters were observed which included: urinary frequency, positive rate of urine culture, histopathological analysis of cystitis stained with hematoxylin and eosin. Results Severe inflammatory responses and massive infiltration of inflammatory cells were observed after the models were established. R11-Cipro group was better than intravenous injection of Cipro group in treating cystitis (P < 0.05). R11-Cipro group was better than the other four groups in urinary frequency and urine culture. Conclusions Intravesical instillation of R11-Cipro demonstrated significant therapeutic effect on bacterial cystitis. R11 , as an efficient vector, could deliver specific antibiotics to bladder mucosa precisely and function well locally.

Distribution and characteristics of initial PSA and PSA velocity in men younger than 50 years without prostate cancer / 中华泌尿外科杂志

Objective To explore the distribution and characteristics of initial PSA and PSA velocity in men younger than years without prostate cancer. Methods PSA in men younger than 50 years without prostate cancer from January 2001 to November 2009 were retrieved retrospectively from our computer center. PSA velocity was calculated if their PSA was measured twice or more. The distributions of initial PSA and PSA velocity were analyzed. The correlations between initial PSA, initial PSA age, and PSA velo-city were also analyzed. Kaplan-meier and log-rank tests were used to estimate the significant difference at the risk of PSA≥ 2.5 ng/ml after initial PSA measurement, stratified by median initial PSA (0.6 ng/ml). Results A total of 4206 men without prostate cancer were included. The median initial PSA value in these men was 0.6 ng/ml. Of these men, 1026 (24.4%), 177 (4.2%), and 90 (2.1%) had an initial PSA≥1.0, ≥2.5, and ≥4.0 ng/ml, respectively. A total of 417 men had their PSA measured these men, 25 (6.0%), 13 (3.1%), and 8 (1.9%) had a PSA velocity≥0.35, ≥0.75, initial PSA age and initial PSA, initial PSA age and PSA velocity, and initial PSA and PSA velocity (correlation coefficient r=0.019, -0.015, and -0.006, respectively; P=0.218, 0.754, and 0.897, respectively). After a follow-up of up to 7.1 years from baseline PSA measurement, the risk of PSA≥2.5 ng/ml, stratified by median initial PSA (0.6 ng/ml) was significantly different (log-rank test, P＜0.001). Conclusions The median baseline PSA and PSA velocity in men younger than 50 years old without prostate cancer are 0.6 ng/ml and 0.03 cancer with an initial PSA higher than median (0.6 ng/ml) have a subsequently higher risk of PSA value ≥2.5 ng/ml.