2019年12月以来,湖北省武汉市发现了多例新型冠状病毒感染的肺炎(NCP)患者,随着疫情的蔓延,我国其他地区及境外也相继发现了相关病例,该病通过基因测序确定为一种新的冠状病毒,世界卫生组织(WHO)将其命名为2019冠状病毒病(Corona Virus Disease 2019,COVID-19).该病毒传染性极强,主要通过飞沫和密切接触的途径传播,泌尿外科老年患者居多,往往伴有不同程度的基础疾病或免疫功能低下,这些特点导致感染NCP机会明显增加,且易发展为重症患者.本文从泌尿外科日常防控工作出发,结合NCP疫情相关国家政策方案及最新研究进展,制定了泌尿外科诊疗防控工作建议.

目的 探讨使用负压清石鞘是否可以降低经皮肾镜碎石术术后感染相关并发症发生率.方法 回顾性分析2018年7月至2019年8月在华中科技大学同济医院行单通道(F20)经皮肾镜碎石术的226例患者资料.根据术中是否使用负压清石鞘分为负压组(n=85)及对照组(n=141).所有手术均采用超声引导下穿刺,建立F20经皮肾通道.统计所有患者基本资料、手术相关参数、术后感染相关并发症发生率等数据.结果 所有患者均顺利完成手术.负压组患者年龄大于对照组[(55.00±10.01)vs.(51.95±12.83)岁,P=0.138].负压组与对照组患者性别比、BMI、术前尿培养阳性史比例、结石大小、手术时间等均无统计学差异.负压组术后全身系统炎症综合征(SIRS)或脓毒血症(sepsis)的发生率低于对照组(2.35％ vs.9.93％,P=0.031),且负压组患者术后住院时间更短[(5.035±1.742)vs.(5.823±2.370)d,P=0.004].结论 采用负压清石鞘可以降低经皮肾镜碎石术术后感染相关并发症发生率,促进患者恢复.

Objective: To evaluate the safety and effectiveness of ultrasound-guided percutaneous nephrolithotomy (PCNL) accessed by SVOF-principle and two-step puncture techniques. Methods: A total of 838 cases with upper urinary stones underwent percutaneous nephrolithotomy successfully accessed by ultrasound-guided between June 2007 and December 2015 at Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. Of all cases were divided in two groups: hydronephrosis calyces puncture group include 425 cases and SVOF-principle puncture group include 413 cases. The access establishment time, operation time, stone free rate (SFR), postoperative complications, and postoperative hospitalization time between the two groups we compared by t test or χ2 test. Results: Statistically significant differences were observed between hydronephrosis calyces puncture group and SVOF-principle puncturegroup in the first access establishment time ((16.5±8.4) minutes vs. (11.2±5.9) minutes, t=3.931, P=0.013), one-stage SFR (74.3% vs. 85.7%, χ2=16.868, P=0.000), postoperative hospitalization time ((6.4±2.1) days vs. (4.8±1.8)days, t=4.574, P=0.000), transfusion rate (7.1% vs. 2.9%, χ2=8.027, P=0.006), and embolization rate (3.3% vs. 1.0%, χ2=5.390, P=0.020). There were no statistically significant differences in operation time, total SFR, postoperative fever and sever infection between these two groups (all P>0.05). In both two groups, no serious complications such as peripheral organ injury and death occurred. Conclusions: PCNL accessed guided by ultrasound with SVOF-principle and two-step puncture techniques has advantages of quick puncture location, high stone free rate, fewer complications and fast recovery. This technique is an effective and safe treatment option for upper urinary stones and deserved promotion and application in clinic.

Objective To investigate the efficacy,safety and the mechanism of intravesical in-stillation of OK-432 (sapylin)by the clinical observation and animal's experiment. Methods ①Clinical research:40 cases diagnosed with bladder tumor which used OK-432 (sapylin)for intravesi-cal instillation in the postoperative period were collected,and determing the content of cytokine TNF-α,INF-γand IL-2 in the urine collected before and after infusion respectively,reviewing the cystoscopy 3 months after operation,and counting the adverse effects.②Animal experiment:divided 75 female rats into five groups:blank control group (15),saline perfusion group (15),sapylin per-fusion group (15),BCG vaccine perfusion group (15),E.coli perfusion group (15),perfusion treat-ment once a week,continuous 6 weeks,then selected 10 rats from each group randomly,killed the rats and took the trigone tissue for pathological salices and immunohistochemical analysis of cytokine TNF-α,INF-γand IL-2.The rest 25 rats just raised after 2 months without any treatment,after 2 months killed the rest rats and took the trigone tissue for pathological salices. Results ①Clinical research:the content of urine cytokine TNF-α,INF-γand IL-2,after perfusion of OK-432 (sapylin)rose significantly,after 6 months reviewed the cystoscopy and reported inflammatory changes,no tumor recurrence,and low incidence of adverse reactions.②Animal experiment:after 6 weeks intravesical instillation with different solutions,infiltration of immune cell in the rat bladder tissue and expression of cytokines TNF-α,INF-γand IL-2 were similar:E.coli group > sa-pylin group ≈BCG group > saline group > blank control group;stopped perfusion 2 months was shown as:E.coli group characterized by bladder inflammatory change,almost all the rest of the group was turn to normal transitional epithelium. Conclusions Sapylin's action mechanism is similar with BCG,mainly through activating the bladder epithelial inflammatory re-action enhance the immune function of the lesion site,and than recognize and eliminate the mutant cells,and can recover to normal transitional epithelium after a period of time,therefore sapylin is a kind of safe and effective immune regulator.

本研究采用科学家形象绘图测试,结合问卷调查,考察了93名中国大学生对科学家的认识.研究发现,大学生对科学家普遍存在刻板印象并呈现出如下特点:相比中小学生,大学生对科学家的认识更加丰富而真实;但多数大学生将科学家的生活与工作等同,缺乏对科学家的全面了解;对科学研究中团队合作的认识不足;女大学生在科学事业中处于边缘化地位.研究还分析了科学教材、科学教育、大众媒体的影响,并提出了相应建议.

Objective:To study the Expression of FABP protein in bladder carcinoma and its significance.Methods:The expression of FABP was detected in 43 cases of bladder carcinoma by immunohistochemistry technique (SABC method). Results:The positive rate of FABP was 72.1% in 43 cases of bladder carcinoma. The expression of FABP correlate well with their clinical stage and degree of pathologic differentiation (P0.05).Conclusions:The expression of FABP protein may reflect the biological behavior and prognosis of bladder carcinoma.