ACUPUNCTURE TREATMENT OF 182 CASES OF ABDOMINAL COLIC DUE TO CALCULI IN THE URINARY SYSTEM

From May 1970 to May 1988,the authortreated 182 cases of abdominal colic due to cal-culi in the urinary system with satisfactory anal-gesic effect,and this is briefly summarized asfollows.

Chinese Herbal Medicine and Acupuncture Used for Rehabilitation of the Impaired Urinary System in Patients with Paraplegia—A Report of 52 Cases

Infection of the urinary system is frequently seen in the paraplegic patients with urinary complications,which is one of the main reasons for the late death in such cases. The effects of the therapeutic method adopted for the urinary rehabilitation are directly related to the life quality and survival time of the paraplegic patients. Since 1999-2002, the authors had applied Chinese herbal medicine combined with acupuncture for the urinary rehabilitation in 52 paraplegic patients, with quite good therapeuticresults as reported in the following.

Utilization of aggregation-induced emission materials in urinary system diseases

With the development of aggregation-induced emission(AIE)materials,the draw-backs of conventionalfluorescence materials subjected to aggregation-caused quenching(ACQ)have been resolved.This has allowed for the improvement of novel AIEfluorescent materials that exhibit enhanced photostability,a higher signal-to-noise ratio,and better imaging quality.Meanwhile,the enhanced phototherapeutic effect of AIE materials has garnered widespread attention in the realm of tumor treatment.The distinct physiological and anatomical characteristics of the urinary system make it suitable for the use of AIE materials.Additionally,AIE-based pho-totherapy provides a superior solution to deal with the weaknesses of conventional treatments for urologic neoplasms.In this review,the scientific advancement on the use of AIE materials in urinary system diseases since the emergence of the AIE con-cept is reviewed in detail.The review highlights the promise of AIE materials for biomarkers detection,fluorescence imaging(FLI)in vivo and in vitro,AIE-based phototherapy,and synergistic therapy from both diagnostic and therapeutic view-points.It isfirmly believed that AIE materials hold immense untapped potential for the diagnosis and treatment of urologic disease,as well as all diseases of the human body.

Beta-lactam antibiotic resistance among Escherichia coli isolates from patients with urinary tract infections in Vietnam:A systematic review and meta-analysis

Objective:To investigate the evolving patterns of antimicrobial resistance against beta-lactam antibiotics in Escherichia coli isolates from urinary tract infection patients in Vietnam,covering the period from 2005 to 2022.Methods:29 Descriptive studies published between 2010 and 2022 in English and Vietnamese were included in the analysis.Data on resistance rates to beta-lactam antibiotics,including cephalosporins and carbapenems,were extracted and analyzed.Weighted pooled resistance rates were calculated using random-effects models.Annual trends in resistance were assessed using linear regression analysis.Results:Among the beta-lactam antibiotics studied,Escherichia coli exhibited varying levels of resistance,with cephalosporins showing higher resistance rates compared to carbapenems.Weighted pooled resistance rates were 66%for cefotaxime,65%for ceftriaxone,54%for ceftazidime,and 56%for cefepime.In contrast,carbapenems demonstrated lower resistance rates,with weighted pooled resistance rates ranging from 3%to 4%for meropenem,ertapenem,and imipenem.Resistance rates were also observed for amoxicillin/clavulanate(35%),ticarcillin/clavulanate(26%),and piperacillin/tazobactam(12%).Significant annual increases in resistance were noted for imipenem(0.56%,P<0.001).Conclusions:This study highlights the critical issue of antimicrobial resistance in urinary tract infections in Vietnam and emphasizes the importance of prudent antibiotic use and the regular monitoring of resistance patterns.These insights are useful for guiding healthcare professionals in optimizing treatment strategies and for policymakers in formulating evidence-based clinical guidelines to combat antibiotic resistance effectively.

The Influence of Anaerobic Bacteria on Human Urinary System

The anaerobic bacteria can cause infections in different parts of the body, including appendicitis, cholecystitis, otitis media, oral infections, endocarditis, endometritis, brain abscess, myocardial necrosis, osteomyelitis, peritonitis, empyema, salpingitis, septic arthritis, liver abscess, sinusitis, intestinal surgery or post-traumatic wound infections, and bacteremia, such as pelvic inflammatory disease. This paper analyzes the experimental method of anaerobic bacteria to human urinary system through the influence of literature.

The risk factors of postpartum urinary retention after vaginal delivery:A systematic review

Objectives:This review aimed to explore the independent risk factors of postpartum urinary retention(PUR)after a vaginal delivery.Methods:The Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)was followed and relevant studies were retrieved from eleven databases.The quality of the included articles was assessed using Critical Appraisal Skills Programme tools or the Appraisal tool for Cross-Sectional Studies.The data analysis was performed using Review Manager version 5.3.Results:A total of nine articles were included and five risk factors were identified,namely,episiotomy(OR=2.99,95%CI=1.31e6.79,P=0.009),epidural analgesia(OR=2.48,95%CI=1.09e5.68,P=0.03),primiparity(OR=2.17,95%CI=1.06e4.46,P=0.03),instrumental delivery(OR=4.01,95%CI=1.97 e8.18,P<0.001),and the duration of the second stage of labor(MD=15.24,95%CI=11.20e19.28,P<0.001).However,fetal birth weights of more than 3800 g were not identified as an independent risk factor(MD=64.41,95%CI=-12.59 to 141.41,P=0.10).Conclusion:This systematic review indicated that the independent risk factors for PUR were found to include episiotomy,epidural analgesia,instrumental delivery,primiparity,and a longer second stage of labor.In clinical practice,healthcare providers could pay more attention to women with these factors and prevent postpartum urinary retention.

Value of Preoperative Neutrophil-to-Lymphocyte Ratio in Predicting Prognosis of Surgically Resectable Urinary Cancers: Systematic Review and Meta-Analysis

Objective Accumulated evidence has suggested that there is a close association between preoperative neutrophilto-lymphocyte ratio(NLR)and prognosis of various malignant tumors.However,the relationship between NLR and surgically resectable urinary cancers remains contradictory.Therefore,we performed this systematic review and meta-analysis to explore whether preoperative NLR could predict the prognosis of surgically resectable urinary cancers.Methods After searching the Embase,PubMed/MEDLINE and Cochrane databases and screening the articles,we finally included 25 studies involving 15950 patients.Hazard ratios(HRs)and their 95%confidence intervals(CIs)were extracted to assess the association between preoperative NLR and the overall survival(OS)and cancerspecific survival(CSS)of surgically resectable urinary cancers.Results The pooled results revealed that an elevated preoperative NLR could predict a worse OS(HR=1.40,95%CI:1.26–1.54,P<0.001)and CSS(HR=1.43,95%CI:1.27–1.59,P<0.001)in urinary cancers.In addition,our analyses also suggested that high preoperative NLR was associated with worse prognosis in renal cell carcinoma(OS:HR=2.06,95%CI:1.54–2.76,P=0.131;CSS:HR=2.46,95%CI:1.46–4.16,P=0.178),upper tract urothelial carcinoma(OS:HR=1.91,95%CI:1.50–2.42,P=0.616;CSS:HR=1.84,95%CI:1.41–2.39,P=0.001),bladder cancer(OS:HR=1.09,95%CI:1.02–1.17,P<0.001;CSS:HR=1.05,95%CI:1.01–1.09,P=0.163)and prostate cancer(OS:HR=1.69,95%CI:1.19–2.41,P=0.714).Regardless of the participants’race or the cutoff value of the preoperative NLR,the results remained valid.Conclusion Elevated preoperative NLR could predict a worse prognosis in surgically resectable urinary cancers,namely,renal cell carcinoma,bladder cancer,prostate cancer and upper tract urothelial carcinoma.

Prostate artery embolization on lower urinary tract symptoms related to benign prostatic hyperplasia: A systematic review and metaanalysis

BACKGROUND Prostate artery embolization(PAE)is a promising minimally invasive therapy that improves lower urinary tract symptoms(LUTS)related to benign prostatic hyperplasia(BPH).Transurethral resection of the prostate(TURP)is the gold standard therapy for LUTS/BPH.AIM To evaluate the efficacy and safety of PAE vs TURP on LUTS related to BPH.METHODS A literature review was performed to identify all published articles on PAE vs TURP for LUTS/BPH.Sources included PubMed,Embase,Cochrane library databases,and Chinese databases before June 2022.A systematic review and meta-analysis were conducted.Outcome measurements were combined by calculating the mean difference with a 95%confidence interval.Statistical analysis was carried out using Review Manager 5.3.RESULTS Eleven studies involving 1070 participants were included.Compared with the TURP group,the PAE group had a similar effect on the International Index of Erectile Function(IPSS)score,Peak urinary flow rate(Qmax),postvoid residual volume(PVR),Prostate volume(PV),prostatic specific antigen(PSA),The International Index of Erectile Function short form(IIEF-5)scores,and erectile dysfunction during 24 mo follow-up.Lower quality of life(QoL)score,lower rate of retrograde ejaculation and shorter hospital stay in the PAE group.There was no participant death in either group.A higher proportion of haematuria,urinary incontinence and urinary stricture was identified in the TURP group.CONCLUSION PAE may be an appropriate option for elderly patients,patients who are not candidates for surgery,and patients who do not want to risk the potential adverse effects of TURP.Studies with large cases and long follow-up time are needed to validate results.

Curriculum integration of urinary system

As the organ-system oriented integration of medical education has been carried out in many domestic medical schools for years,an urgent need of discussions on various problems of integrated medical education emerges.This paper reviews the urinary integrated educational work in Shanghai Jiao Tong University School of Medicine(SJTU-MS)and introduces the contents of the integrated curriculum of urinary system.We focus on whether we should apply the single cycle integration mode or dual cycle mode,and compare the vocational medical education and elite medical education,and demonstrate the importance of inter-system integration and the ideal integrated textbooks.Multifarious teaching methods and other issues are also mentioned.The future development of integrated medical education is prospected positively.

Acupuncture and moxibustion treating lower urinary tract symptoms due to benign prostatic hyperplasia:a systematic review and network meta-analysis

Objective: Lower urinary tract symptoms(LUTS) caused by benign prostatic hyperplasia(BPH) affect the quality of life of elderly individuals. Acupuncture and moxibustion are used in the clinic in China for improving LUTS symptoms due to BPH. However,there is no evidence to suggest which is the best option. We compared the efficacy of acupuncture and moxibustion to provide evidence for clinical decision-making.Methods: PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wan Fang Data, and VIP databases were searched from inception to July 2020 to identify the randomized controlled trials(RCTs) of acupuncture and moxibustion for LUTS due to BPH. Two researchers filtered studies and extracted the information independently. This study conducted a network meta-analysis using the Bayesian random method. The interventions ranking was evaluated using the surface under the cumulative ranking curve(SUCRA).Results: We finally included 40 studies comprising 10 treating therapies and 3,655 patients with LUTS caused by BPH. In terms of the International Prostate Symptom Score, maximum urinary flow rate, and quality of life, electroacupuncture(EA) [MD =-3.6,95% credible interval(CrI)(-5.5,-1.8), very low certainty of evidence;MD = 2.2, 95% CrI(1.1, 3.3), low certainty of evidence;MD =-1.3, 95% CrI(-2.2,-0.43), very low certainty of the evidence] may be consistently the optimal treatment compared with other interventions, with SUCRA values of 84%, 81%, and 89%, respectively.Conclusions: Of all treatments, EA may have the best efficacy with fewer adverse events for LUTS due to BPH. The quality of evidence supporting this result is low to very low certainty of the evidence due to the limitations of primary studies;thus, more highquality RCTs are needed for further evidence.

Urinary exosomal microRNA-145-5p and microRNA-27a-3p act as noninvasive diagnostic biomarkers for diabetic kidney disease

BACKGROUND Diabetic kidney disease(DKD),characterized by increased urinary microalbumin levels and decreased renal function,is the primary cause of end-stage renal di-sease.Its pathological mechanisms are complicated and multifactorial;Therefore,sensitive and specific biomarkers are needed.Urinary exosome originate from diverse renal cells in nephron segments and partially mirror the pathological changes in the kidney.The microRNAs(miRNAs)in urinary exosome are remark-ably stable and highly tissue-specific for the kidney.METHODS Type 2 diabetic mellitus(T2DM)patients were recruited from the Second Hospital of Hebei Medical University and were divided into two groups:DM,diabetic pa-tients without albuminuria[urinary albumin to creatinine ratio(UACR)<30 mg/g]and DKD,diabetic patients with albuminuria(UACR≥30 mg/g).Healthy subjects were the normal control(NC)group.Urinary exosomal miR-145-5p,miR-27a-3p,and miR-29c-3p,were detected using real-time quantitative polymerase chain reaction.The correlation between exosomal miRNAs and the clinical in-dexes was evaluated.The diagnostic values of exosomal miR-145-5p and miR-27a-3p in DKD were determined using receiver operating characteristic(ROC)analysis.Biological functions of miR-145-5p were investigated by performing RESULTS Urinary exosomal expression of miR-145-5p and miR-27a-3p was more upregulated in the DKD group than in the DM group(miR-145-5p:4.54±1.45 vs 1.95±0.93,P<0.001;miR-27a-3p:2.33±0.79 vs 1.71±0.76,P<0.05)and the NC group(miR-145-5p:4.54±1.45 vs 1.55±0.83,P<0.001;miR-27a-3p:2.33±0.79 vs 1.10±0.51,P<0.001).The exosomal miR-145-5p and miR-27a-3p positively correlated with albuminuria and serum creatinine and negatively correlated with the estimated glomerular filtration rate.miR-27a-3p was also closely related to blood glucose,gly-cosylated hemoglobin A1c,and low-density lipoprotein cholesterol.ROC analysis revealed that miR-145-5p had a better area under the curve of 0.88[95%confidence interval(CI):0.784-0.985,P<0.0001]in diagnosing DKD than miR-27a-3p with 0.71(95%CI:0.547-0.871,P=0.0239).Bioinformatics analysis revealed that the target genes of miR-145-5p were located in the actin filament,cytoskeleton,and extracellular exosome and were involved in the pathological processes of DKD,including apoptosis,inflammation,and fibrosis.CONCLUSION Urinary exosomal miR-145-5p and miR-27a-3p may serve as novel noninvasive diagnostic biomarkers or promising therapeutic targets for DKD.

Correlation between Combined Urinary Metal Exposure and Grip Strength under Three Statistical Models:A Cross-sectional Study in Rural Guangxi

Objective This study aimed to investigate the potential relationship between urinary metals copper(Cu),arsenic(As),strontium(Sr),barium(Ba),iron(Fe),lead(Pb)and manganese(Mn)and grip strength.Methods We used linear regression models,quantile g-computation and Bayesian kernel machine regression(BKMR)to assess the relationship between metals and grip strength.Results In the multimetal linear regression,Cu(β=−2.119),As(β=−1.318),Sr(β=−2.480),Ba(β=0.781),Fe(β=1.130)and Mn(β=−0.404)were significantly correlated with grip strength(P<0.05).The results of the quantile g-computation showed that the risk of occurrence of grip strength reduction was−1.007(95%confidence interval:−1.362,−0.652;P<0.001)when each quartile of the mixture of the seven metals was increased.Bayesian kernel function regression model analysis showed that mixtures of the seven metals had a negative overall effect on grip strength,with Cu,As and Sr being negatively associated with grip strength levels.In the total population,potential interactions were observed between As and Mn and between Cu and Mn(P_(interactions) of 0.003 and 0.018,respectively).Conclusion In summary,this study suggests that combined exposure to metal mixtures is negatively associated with grip strength.Cu,Sr and As were negatively correlated with grip strength levels,and there were potential interactions between As and Mn and between Cu and Mn.

Prediction of Renal Function by Urinary Lead and Cadmium - Based on Classification Decision Tree and Logistic Regression Model

It is estimated that chronic kidney disease(CKD)will be the fifth leading cause of death in the world by 2040[1].Early recognition and intervention for kidney damage are essential.Estimated glomerular filtration rate(eGFR)can be calculated by measuring blood creatinine to evaluate glomerular function,and urinary N-acetyl-β-δ-glucosaminidase(UNAG)level is generally recognized as a marker of renal tubular injury.Exposure to lead(Pb)and cadmium(Cd)can damage renal function,leading to a decrease in eGFR and an increase in UNAG[2].Both Pb and Cd are easily accumulated in the body and then slowly released by the kidneys and excreted.So,urinary Pb(UPb)and Cd(UCd)levels can be used as biomarkers of exposure[3,4].

Etiology and management of urethral calculi:A systematic review of contemporary series

Objective:To conduct a systematic literature review on urethral calculi in a contemporary cohort describing etiology,investigation,and management patterns.Methods:A systematic search of MEDLINE and Cochrane Central Register of Controlled Trials(CENTRAL)databases was performed.Articles,including case reports and case series on urethral calculi published between January 2000 and December 2019,were included.Full-text manuscripts were reviewed for clinical parameters including symptomatology,etiology,medical history,investigations,treatment,and outcomes.Data were collated and analyzed with univariate methods.Results:Seventy-four publications met inclusion criteria,reporting on 95 cases.Voiding symptoms(41.1%),pain(40.0%),and acute urinary retention(32.6%)were common presenting features.Urethral calculi were most often initially investigated using plain X-ray(63.2%),with almost all radio-opaque(98.3%).Urethral calculi were frequently associated with coexistent bladder or upper urinary tract calculi(16.8%)and underlying urethral pathology(53.7%)including diverticulum(33.7%)or stricture(13.7%).Urethral calculi were most commonly managed with external urethrolithotomy(31.6%),retrograde manipulation(22.1%),and endoscopic in situ lithotripsy(17.9%).Conclusion:This unique systematic review of urethral calculi provided a summary of clinical features and treatment trends with a suggested treatment algorithm.Management in contemporary urological practice should be according to calculus size,shape,anatomical location,and presence of urethral pathology.

Urinary metabolic profiles during Helicobacter pylori eradication in chronic gastritis

BACKGROUND Helicobacter pylori(H.pylori)infection is a major risk factor for chronic gastritis,affecting approximately half of the global population.H.pylori eradication is a popular treatment method for H.pylori-positive chronic gastritis,but its mecha-nism remains unclear.Urinary metabolomics has been used to elucidate the mechanisms of gastric disease treatment.However,no clinical study has been conducted on urinary metabolomics of chronic gastritis.AIM To elucidate the urinary metabolic profiles during H.pylori eradication in patients with chronic gastritis.METHODS We applied LC–MS-based metabolomics and network pharmacology to in-vestigate the relationships between urinary metabolites and H.pylori-positive chronic gastritis via a clinical follow-up study.RESULTS Our study revealed the different urinary metabolic profiles of H.pylori-positive chronic gastritis before and after H.pylori eradication.The metabolites regulated by H.pylori eradication therapy include cis-aconitic acid,isocitric acid,citric acid,L-tyrosine,L-phenylalanine,L-tryptophan,and hippuric acid,which were involved in four metabolic pathways:(1)Phenylalanine metabolism;(2)phenylalanine,tyrosine,and tryptophan biosynthesis;(3)citrate cycle;and(4)glyoxylate and dicarboxylate metabolism.Integrated metabolomics and network pharmacology revealed that MPO,COMT,TPO,TH,EPX,CMA1,DDC,TPH1,and LPO were the key proteins involved in the biological progress of H.pylori eradication in chronic gastritis.CONCLUSION Our research provides a new perspective for exploring the significance of urinary metabolites in evaluating the treatment and prognosis of H.pylori-positive chronic gastritis patients.

24-Hour Urinary Sodium Excretion Association with Cardiovascular Events:A Systematic Review and Dose-Response Meta-Analysis

Objective The relationship between sodium intake and cardiovascular(CV)events remains unconfirmed.Therefore,we carried out a systematic review and dose-response meta-analysis for evaluating the potential impact of 24-hour sodium excretion on CV risk.Besides,24-hour sodium excretion was used to replace daily sodium diet intake.Methods We searched ISI Web of Science,Embase,Pub Med,and the Cochrane Library.Our study included cohort studies reporting hazard ratio(HR).The random-effects model was used for summarizing the total relative risks(RRs)between the included studies.In addition,the generalized least-squares regression was employed to fit the study model.Results A total of 9 studies involving 645,006 participants were included in this study.A significant non-linear relationship was observed between sodium excretion and CV events(P^(non-linearity)<0.001).In studies collecting 24-h urine samples,the sodium excretion and CV events risk were associated linearly(RR:1.04;95%CI:1.01,1.07).Conclusion In a linear dose-response manner,every 1 g increase in sodium intake was associated with an increased risk of CV events up to 4%.Further studies are required to validate our conclusions further.

Design and Implementation of a Real Time Wireless Monitor System for Urinary Incontinence

Urinary incontinence is the most common health problem in aged people. Leaving incontinence events unmanaged will make a negative influence on the aged and the patient both mentally and physically. This paper presents a design and implementation of a real time wireless monitor system for urinary incontinence, which has been applied in two nursing homes in Beijing and Shanghai. We collect real time moisture information by using non-contact humidity sensor designed and manufactured by us. When urinary incontinence, the sensor will send alert to mobile device via Bluetooth. If got the alert, the mobile device will send the alert to relatives of the aged or disabled people and cloud computing platform, through which we can make this information managed and displayed and the paramedic can be informed about the alarm. This paper gives a brief introduction to the framework of this system, the design of the non-contact sensor, the transmission of wireless data and the results of tests.

Lymphoepithelioma-like carcinoma of the upper urinary tract: A systematic review of case reports

BACKGROUND Lymphoepithelioma-like carcinomas(LELCs)are rare,malignant epithelial tumors,generally considered a subtype of squamous cell carcinoma.LELCs are undifferentiated and can occur in multiple tissues,although LELCs in the urinary tract are extremely rare.As such,evidence does not provide clinicians with guidelines for the best practices.Even though this is a rare disease,it is associated with high morbidity and mortality.Therefore,we must learn to differentiate LELC types and identify risk factors for early identification.AIM To develop an evidence base to guide clinicians treating primary LELCs of the upper urinary tract(UUT-LELC).METHODS We performed a systematic review of all reports on UUT-LELC from the first published case in 1998 until October 2019,according to the PRISMA.A database was then developed by extracting data from previously published reports in order to analyze interactions between clinical characteristics,pathological features,interventions and outcomes.Survival was analyzed using Kaplan–Meier estimates,which were compared using log rank tests.RESULTS A total of 28 previously published cases were identified for inclusion.The median age was 72 years with a male to female ratio of 4:3.Pure type LELCs were most common with 48.3%(n=14),followed by 37.9%(n=11)predominant LELCs and 3.4%(n=1)focal LELCs.Epstein-Barr virus testing was negative in all cases.Fourteen patients received radical nephroureterectomy(RNU)-based intervention.Twenty-three patients survived with no evidence of further metastasis,although six died before the median 18 mo follow-up point.Survival analysis suggests pure histological subtypes,and patients who receive complete tumor resection have more favorable prognoses.As always in cancer care,early identification generally increases the probability of interventional success.CONCLUSION The most effective treatment for UUT-LELC is RNU-based therapy.Since cases are few in number,case reporting must be enhanced and publishing encouraged to both save and prolong lives.

Antibiotics for complicated urinary tract infection and acute pyelonephritis: A systematic review

BACKGROUND The increasing rates of antibiotic-resistance in the recent years has caused the emergence of multiple drug-resistant bacteria.Therefore,antibiotics that are recommended by the current clinical guidelines may not be effective for the treatment of complicated urinary tract infection(UTI)and acute pyelonephritis.AIM To determine the clinical efficacy and safety of antibiotics for the treatment of complicated urinary tract infection and acute pyelonephritis.METHODS A search of three medical databases(PubMed,EMBASE and Google Scholar)were conducted for eligible articles describing the use of antibiotics in managing complicated UTI and acute pyelonephritis.The following keywords were used to perform the literature search:“urinary tract infection”,“complicated UTI”,“pyelonephritis”,“treatment”and“antibiotics”.Additional articles of interest were retrieved from the reference list of selected papers.Eligibility criteria for this systematic review were diagnosis of either complicated urinary tract infection or acute pyelonephritis and the use of antibiotics in management.Clinical trials and observational studies were included in this review while case reports and reviews were excluded.The methodological quality of clinical trials and observational studies was assessed.A descriptive approach was adopted to analyze the data due to the variation of methodology and interventions.RESULTS A total of 183 studies were screened;eight studies that matched all the eligibility criteria were included in this review.The antibiotics included in this systematic review were ceftazidime-avibactam,doripenem,levofloxacin,meropenemvaborbactam,piperacillin-tazobactam,plazomicin,tazobactam-ceftolozane and gentamicin.Two clinical trials reported that shorter duration of levofloxacin or non-fluoroquinolone antibiotics treatment was as effective as the duration of antibiotic therapy recommended by the current guidelines in treating complicated UTI and pyelonephritis.Besides that,ceftazidime-avibactam,piperacillintazobactam and tazobactam-ceftolozane can be used as an alternative to carbapenem in treating extended-spectrumβ-lactamase-producing Escherichia coli.In the included studies,the cure rates of the complicated UTI and pyelonephritis by meropenem-vaborbactam,piperacillin-tazobactam and tazobactam-ceftolozane was comparable at between 95.6%and 98.4%.Furthermore,the clinical trials showed that levofloxacin had a relatively high rate of adverse events(33.1%and 47.7%in two clinical trials)while tazobactamceftolozane had a relatively low rate of adverse events(17.5%).All studies have limitations and a potential for bias.CONCLUSION The use of novel antibiotics and combination antibiotic therapy can be considered in treating complicated UTI and acute pyelonephritis when resistance to recommended antibiotics occurs.

Design of a Noninvasive Bladder Urinary Volume Monitoring System Based on Bio-Impedance

For the needs of bladder urinary volume noninvasive monitoring in clinical, we present a noninvasive bladder urinary volume monitoring system based on bio-impedance. The system uses a four-electrode structure,which is composed of a pair of excitation electrodes and a pair of measurement electrodes. The Direct Digital Frequency Synthesis (DDS) is applied to generate a 50 kHz sine current excitation source. The impedance information extracted from phase sensibility demodulation technology is transferred to a computer through Zigbee wireless technology for real-time monitoring. Two experiments are taken to verify the accuracy and feasibility of the system. The experiments results show that the system can accurately measure the corresponding electrical impedance change of the bladder. The system provides a new way to continuously and noninvasively monitor the bladder urinary volume of patients with bladder dysfunction.