Radical cystectomy, as the most common surgical treatment for patients with invasive bladder cancer (IBC) complicated by peritoneal metastasis, is usually accompanied by a urinary diversion procedure. In this study, we evaluated the improved tubeless cutaneous ureterostomy technique by comparing the resulting clinical effects with either a traditional ureterostomy and an ileal conduit urinary diversion. Clinical data from 85 patients who underwent 1 of the 3 procedures between April 2012 and April 2015 were analyzed retrospectively. In total, 30 patients underwent improved tubeless cutaneous ureterostomy, 28 patients underwent a traditional cutaneous ureterostomy and 27 underwent an ileal conduit urinary diversion following radical cystectomy. The incidence of complications, including stoma infection, nipple atrophy, terminal necrosis, urine leakage, external orifice stenosis, uronephrosis and ureterectasia in the group of patients treated with the improved tubeless ureterostomy technique was significantly lower than that of the patients in the other 2 groups, and the difference was statistically significant (P<0.05). In addition, the duration of the surgery, intra-operative bleeding, the duration of the hospitalization period and the time to extubation in the patients treated with the improved tubeless ureterostomy technique were significantly decreased (P<0.05) compared with the patients in the other 2 groups. Finally, the health-related quality of life of the patients treated with the improved tubeless ureterostomy technique was significantly higher (P<0.05) than that of the patients in the other 2 groups. The findings of our study demonstrated that the use of the improved tubeless cutaneous ureterostomy technique following radical cystectomy in patients with IBC complicated by peritoneal metastasis resulted in improved clinical effects. Thus, improved tubeless cutaneous ureterostomy may be a promising alternative for enhancing the quality of life of patients with IBC.

Background: We aimed to investigate the effects of occupational stress on blood lipids, blood glucose and immune function of doctors. Methods: In 2017, 1291 doctors (565 males, 726 females) in The First Hospital Affiliated with Harbin Medical University (Harbin, China) were enrolled based on the principle of convenience of sampling and cluster sampling. Questionnaires were used to investigate demographic characteristics and occupational stress related factors. Level of glycated hemoglobin was detected by immunoturbidimetric method. Concentration of triglyceride was determined by        glycerol phosphate oxidase end point method. Total cholesterol concentration in serum was determined by total cholesterol oxidase end point method. Concentration of serum immunoglobulin was detected by immunoturbidimetry. Results: Levels of glycated hemoglobin and triglyceride in high tension group were higher than those in the low tension group. Levels of IgG and IgM in high tension group were lower than those in low tension group. The risk of elevated glycated hemoglobin levels in > 50-yr-old age group was higher than that of the =<35-yr-old age group. Those in the high coping strategy group was higher in the low coping strategy group. The risk of elevated total cholesterol levels in drinkers is 1.158 times that of non-drinkers. The risk of IgG concentration reduction in smokers was 0.428 times that of non-smokers. The risk of a decrease in IgA concentration in doctors with good sleep quality is 1.527 times that of those with poor sleep quality. Conclusion: Occupational stress can lead to increased blood lipids and sugar levels as well suppression of immune function in doctors.