OBJECTIVE: To systematically assess the effects of individualized Chinese medicines on recurrent urinary tract infections(rUTIs).METHODS: This study recruited 230 adult female patients in the remission phase of rUTIs ...OBJECTIVE: To systematically assess the effects of individualized Chinese medicines on recurrent urinary tract infections(rUTIs).METHODS: This study recruited 230 adult female patients in the remission phase of rUTIs from five hospitals in China. The patients were randomly allocated to two groups: an individualized Chinese medicine group(n = 114) and a control group(n = 116). Patients in the Chinese medicine group received individualized Chinese herbs, which were evaluated for syndrome differentiation.Patients in the control group received antibiotic treatment combined with a Chinese medicine placebo. The duration of treatment was three courses of four weeks each, with a three-month subsequent follow-up. UTI recurrence rate,Traditional Chinese Medicine(TCM) syndrome scores,36-item Short Form Survey(SF-36) score, and urine secretory immunoglobulin A(SIgA) were measured and analyzed before and after treatment in each group. RESULTS: Patients from the Chinese medicine group exhibited significant decreases in both short-and longterm UTI recurrence rates compared with the control group(P < 0.05). The changes in TCM syndrome scores between the Chinese medicine and control groups were significant(P < 0.05). The changes in the average SF-36 quality-of-life scores in the Chinese medicine group were also significantly higher than those in the control group after treatment(P < 0.05). The Chinese medicine group also demonstrated a significant increase in urine SIg A expression. CONCLUSION: Taken together, compared to the oftenused long-term antimicrobial prophylaxis during the remission stage of r UTIs, treating patients with an individualized Chinese medicine decoction by syndrome differentiation could effectively reduce the recurrence rate, improve the patients' TCM syndrome scores and quality of life, and enhance immunity, which in turn helps to prevent antibiotic resistance.展开更多
AIM To determine whether recent evidence-based United States polices on male circumcision(MC) apply to comparable Anglophone countries,Australia and New Zealand.METHODS Articles in 2005 through 2015 were retrieved fro...AIM To determine whether recent evidence-based United States polices on male circumcision(MC) apply to comparable Anglophone countries,Australia and New Zealand.METHODS Articles in 2005 through 2015 were retrieved from PubM ed using the keyword "circumcision" together with 36 relevant subtopics.A further PubM ed search was performed for articles published in 2016.Searches of the EMBASE and Cochrane databases did not yield additional citable articles.Articles were assessed for quality and those rated 2+ and above according to the Scottish Intercollegiate Grading System were studied further.The most relevant andrepresentative of the topic were included.Bibliographies were examined to retrieve further key references.Randomized controlled trials,recent high quality systematic reviews or meta-analyses(level 1++ or 1+ evidence) were prioritized for inclusion.A risk-benefit analysis of articles rated for quality was performed.For efficiency and reliability,recent randomized controlled trials,metaanalyses,high quality systematic reviews and large welldesigned studies were used if available.Internet searches were conducted for other relevant information,including policies and Australian data on claims under Medicare for MC.RESULTS Evidence-based policy statements by the American Academy of Pediatrics(AAP) and the Centers for Disease Control and Prevention(CDC) support infant and later age male circumcision(MC) as a desirable public health measure.Our systematic review of relevant literature over the past decade yielded 140 journal articles that met our inclusion criteria.Together,these showed that early infant MC confers immediate and lifelong benefits by protecting against urinary tract infections having potential adverse long-term renal effects,phimosis that causes difficult and painful erections and "ballooning" during urination,inflammatory skin conditions,inferior penile hygiene,candidiasis,various sexually transmissible infections in both sexes,genital ulcers,and penile,prostate and cervical cancer.Our risk-benefit analysis showed that benefits exceeded procedural risks,which are predominantly minor,by up to 200 to 1.We estimated that more than 1 in 2 uncircumcised males will experience an adverse foreskin-related medical condition over their lifetime.Wide-ranging evidence from surveys,physiological measurements,and the anatomical location of penile sensory receptors responsible for sexual sensation strongly and consistently suggested that MC has no detrimental effect on sexual function,sensitivity or pleasure.United States studies showed that early infant MC is cost saving.The evidence supporting early infant MC has further strengthened since the positive AAP and CDC reviews.CONCLUSION Affirmative MC policies are needed in Australia and New Zealand.Routine provision of accurate,unbiased education,and access in public hospitals,will maximize health and financial benefits.展开更多
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...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.展开更多
Background:Purple urine bag syndrome(PUBS)is an unusualconditionin which a purple discoloration of urine and bag occurs in people with urinary catheters.People with purple urine usually do not complain of any symptoms...Background:Purple urine bag syndrome(PUBS)is an unusualconditionin which a purple discoloration of urine and bag occurs in people with urinary catheters.People with purple urine usually do not complain of any symptoms.The purple discoloration of the urine bag is often the only finding,frequently noted by caregivers.Materials and methods:This prospective observational study was conducted at our tertiary care institute from June 2018 to May 2020.A total of 46 patients with PUBS wereincluded in this study.The objective of our study was to record the prevalence of each predisposing factor and to correlate the pathological mechanism through which the PUBS is manifested.Results:The mean age of PUBS patients was 67.4years and 67.4%were males.Most patients of PUBS(60.9%)had a urethral catheter,while there was percutaneous nephrostomy in 26.1%patients and 13%patients had a percutaneous suprapubic cystostomy catheter.Among the patients,69.65%were bedridden orin an institutionalized situation,73.9%were suffering from chronic constipation,21.7%were associated with dementia,and 47.8%were cerebrovascular accidents with hemiparesis patients.In addition,93.5%of patients presented with alkaline urine and 3 patients with acidic urine.The most common bacteria isolated in urine culture were E coli and Pseudomonas.Conclusions:Urinary catheter associated urinary tract infection and PUBS is most commonly documented in females,but our study showed that it is more common in males.The appearance of a purple bag does not depend on the material and type of the catheter or the catheterization method.In addition,no correlation was found between the microorganisms isolated from the environment and patients'urine.展开更多
基金TCM Guidance Project of Shanghai Science and Technology Commission:Study on TCM Syndrome Differentiation and Treatment Scheme for Chronic Urinary Tract Infection (No. 13401904600)。
文摘OBJECTIVE: To systematically assess the effects of individualized Chinese medicines on recurrent urinary tract infections(rUTIs).METHODS: This study recruited 230 adult female patients in the remission phase of rUTIs from five hospitals in China. The patients were randomly allocated to two groups: an individualized Chinese medicine group(n = 114) and a control group(n = 116). Patients in the Chinese medicine group received individualized Chinese herbs, which were evaluated for syndrome differentiation.Patients in the control group received antibiotic treatment combined with a Chinese medicine placebo. The duration of treatment was three courses of four weeks each, with a three-month subsequent follow-up. UTI recurrence rate,Traditional Chinese Medicine(TCM) syndrome scores,36-item Short Form Survey(SF-36) score, and urine secretory immunoglobulin A(SIgA) were measured and analyzed before and after treatment in each group. RESULTS: Patients from the Chinese medicine group exhibited significant decreases in both short-and longterm UTI recurrence rates compared with the control group(P < 0.05). The changes in TCM syndrome scores between the Chinese medicine and control groups were significant(P < 0.05). The changes in the average SF-36 quality-of-life scores in the Chinese medicine group were also significantly higher than those in the control group after treatment(P < 0.05). The Chinese medicine group also demonstrated a significant increase in urine SIg A expression. CONCLUSION: Taken together, compared to the oftenused long-term antimicrobial prophylaxis during the remission stage of r UTIs, treating patients with an individualized Chinese medicine decoction by syndrome differentiation could effectively reduce the recurrence rate, improve the patients' TCM syndrome scores and quality of life, and enhance immunity, which in turn helps to prevent antibiotic resistance.
文摘AIM To determine whether recent evidence-based United States polices on male circumcision(MC) apply to comparable Anglophone countries,Australia and New Zealand.METHODS Articles in 2005 through 2015 were retrieved from PubM ed using the keyword "circumcision" together with 36 relevant subtopics.A further PubM ed search was performed for articles published in 2016.Searches of the EMBASE and Cochrane databases did not yield additional citable articles.Articles were assessed for quality and those rated 2+ and above according to the Scottish Intercollegiate Grading System were studied further.The most relevant andrepresentative of the topic were included.Bibliographies were examined to retrieve further key references.Randomized controlled trials,recent high quality systematic reviews or meta-analyses(level 1++ or 1+ evidence) were prioritized for inclusion.A risk-benefit analysis of articles rated for quality was performed.For efficiency and reliability,recent randomized controlled trials,metaanalyses,high quality systematic reviews and large welldesigned studies were used if available.Internet searches were conducted for other relevant information,including policies and Australian data on claims under Medicare for MC.RESULTS Evidence-based policy statements by the American Academy of Pediatrics(AAP) and the Centers for Disease Control and Prevention(CDC) support infant and later age male circumcision(MC) as a desirable public health measure.Our systematic review of relevant literature over the past decade yielded 140 journal articles that met our inclusion criteria.Together,these showed that early infant MC confers immediate and lifelong benefits by protecting against urinary tract infections having potential adverse long-term renal effects,phimosis that causes difficult and painful erections and "ballooning" during urination,inflammatory skin conditions,inferior penile hygiene,candidiasis,various sexually transmissible infections in both sexes,genital ulcers,and penile,prostate and cervical cancer.Our risk-benefit analysis showed that benefits exceeded procedural risks,which are predominantly minor,by up to 200 to 1.We estimated that more than 1 in 2 uncircumcised males will experience an adverse foreskin-related medical condition over their lifetime.Wide-ranging evidence from surveys,physiological measurements,and the anatomical location of penile sensory receptors responsible for sexual sensation strongly and consistently suggested that MC has no detrimental effect on sexual function,sensitivity or pleasure.United States studies showed that early infant MC is cost saving.The evidence supporting early infant MC has further strengthened since the positive AAP and CDC reviews.CONCLUSION Affirmative MC policies are needed in Australia and New Zealand.Routine provision of accurate,unbiased education,and access in public hospitals,will maximize health and financial benefits.
文摘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.
文摘Background:Purple urine bag syndrome(PUBS)is an unusualconditionin which a purple discoloration of urine and bag occurs in people with urinary catheters.People with purple urine usually do not complain of any symptoms.The purple discoloration of the urine bag is often the only finding,frequently noted by caregivers.Materials and methods:This prospective observational study was conducted at our tertiary care institute from June 2018 to May 2020.A total of 46 patients with PUBS wereincluded in this study.The objective of our study was to record the prevalence of each predisposing factor and to correlate the pathological mechanism through which the PUBS is manifested.Results:The mean age of PUBS patients was 67.4years and 67.4%were males.Most patients of PUBS(60.9%)had a urethral catheter,while there was percutaneous nephrostomy in 26.1%patients and 13%patients had a percutaneous suprapubic cystostomy catheter.Among the patients,69.65%were bedridden orin an institutionalized situation,73.9%were suffering from chronic constipation,21.7%were associated with dementia,and 47.8%were cerebrovascular accidents with hemiparesis patients.In addition,93.5%of patients presented with alkaline urine and 3 patients with acidic urine.The most common bacteria isolated in urine culture were E coli and Pseudomonas.Conclusions:Urinary catheter associated urinary tract infection and PUBS is most commonly documented in females,but our study showed that it is more common in males.The appearance of a purple bag does not depend on the material and type of the catheter or the catheterization method.In addition,no correlation was found between the microorganisms isolated from the environment and patients'urine.