Objective Spastic pelvic floor syndrome (SPFS) is a common chronic functional constipation characterized by irregular defecation,low defecation frequency,difficult defecation,and discomfort and pain in the anus and perineum.The pathophysiologic mechanism of the disease has not yet been clearly understood,so there is no targeted treatment.At present,biofeedback therapy is an effective,safe and non-invasive method for the treatment of spastic pelvic floor syndrome,which is often combined with Chinese medicine and psychological intervention in clinical treatment.

Objective:To analyze the clinical and echocardiographic features of constrictive pericarditis. Methods: Thirty-six patients diagnosed as having constrictive pericarditis from Oct. 1989 to Jun. 2007 were enrolled in this retrospective study. Clinical manifestations and echocardiographic features were analyzed. Results: The main clinical manifestations were fatigue, effort dyspnea(100%), and sign of pressure elevation of vena cava(97%). Echocardiographic features included thickening of pericardium(67%), abnormal motion of septal and posterior wall of left ventricle in diastole(83%,75% respectively), left and right atrial enlargement(92%,39% respectively), early filling changes of mitral flow with respiration(93%), inferior vena cava dilation and without respiration variation(100%), mitral annulus paradoxical enhanced motion in early diastole. Conclusion: Clinical manifestations of pressure elevation of vena cava were indicators for diagnosis of constrictive pericarditis. Echocardiography could be a valuable method for confirming the diagnosis.

Objective:To explore the clinical effect of negative pressure wound therapy and to discuss the ethi-cal issues in this therapy and seek a solution. Methods:Sixty patients with negative pressure wound therapy in our hospital were invited to participate in this study. Patients were all with deep pressure ulcers or diabetic foot, of which the Wagner Scores were graded as three or four. They were divided into two groups randomly. The subjects in control group received standard treatment, while those in experimental group were treated by self -designed closed negative pressure drainage settings. The wound healing time, the cost of the treatment and comfort were compared between the two groups. Results:The cost of wound care in the experimental group was less than those in the control group (P<0. 001). There was no significant difference in comfort between two groups (P>0. 05). But the wound healing time was longer in the experimental group than those in the control group. Conclusion:Self-designed closed negative pressure settings can decrease the cost of patient care with the equal patient comfort and acceptance as the standard negative pressure, however, the wound healing time has been extended. So before using negative pressure technique, the medical staff should comprehensively analyze, be guided by medical ethics and choose the appropriate treatment for different patients.

Objective To evaluate Left ventricular(LV) diastolic function in essential hypertension by conventional pulse-wave Doppler echocardiography (cPWD) and Doppler tissue imaging (DTI) and compare the two modalities. Methods Two hundred patients with essential hypertension were classified as NLVH subgroup (n = 160) and LVH subgroup (n =40) based on left ventricular mass index (LVMI) with one hundred and sixty health subjects as control group. The mitral valve flow pattern (MVFP) was obtained.Early diastolic (E) and late velocities (A) were measured and E/A was calculated. DTI was used to obtain the left ventricular lateral wall early diastolic mitral annulus velocity (Em) and E/Em was calculated.Results Essential hypertension patients had LV diastolic dysfunction both by cPWD (higher E and lower E/A ratio) and DTI (lower Em and higher E/Em ratio) compared with healthy subjects [E:(0. 88 ±0. 18)cm/s vs (0. 76 ±0. 19) cm/s;E/A ratio:0. 86 ±0. 28 vs 1.02 ±0. 38;Em: (9. 4 ±2. 8)cm/s vs (11. 9 ±3. 8)cm/s;E/Em ratio;7. 9 ± 2. 7 vs 6. 0 ± 1. 8: with all P value ＜0.01]. Em was significantly reduced and E/Em was significantly elevated in LVH subgroup than NLVH subgroup [Em; (7.7 ±2. 6) cm/s vs (9. 9 ± 2. 8) cm/s, E/Em: 9. 6 ± 3. 6 vs 7. 4 ± 2. 4, P ＜ 0. 05]. No significant difference was found in A and E/A between these two subgroups [(0. 90 ± 0. 22) cm/s vs (0. 87 ± 0. 17) cm/s; 0. 80 ± 0. 34 vs 0.88 ±0.28, P ＞ 0.05]. Conclusions cPWD and DTI both had implications to detect diastolic dysfunction in non-hypertrophic stage hypertension. Em、E/Em could be more sensitive and precise to reflect the impairment of diastolic function in the progress of hypertension.

OBJECTIVE:To investigate the effect of atorvastatin calcium on the carotid intima-media thickness(IMT)and other related indicators in patients with metabolic syndrome(MS). METHODS:The data of 1 444 patients with MS were retrospectively analyzed and randomly divided into observation group(874 cases)and control group(570 cases)by different medication. All patients were given healthy lifestyle,antihypertensive,hypoglycemia and lowering blood lipid guidance. On this basis,treatment group was orally given atorvastatin calcium 20 mg,once every evening. The follow-up was conducted for 3 years. The clinic data in 2 groups was compared,including body mass index(BMI),waist circumference(WC),systolic blood pressure(SBP),diastolic blood pressure (DBP),pulse pressure(PP),IMT,total cholesterol(TC),triglyceride(TG),low conspired lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),high-sensitivity C-reactive protein(hs-CRP),fasting plasma glucose(FPG)and incidence of adverse reactions before and after treatment. RESULTS:After treatment,compared with before and control group,the BMI、WC、SBP、DBP、PP、IMT、TC、TG、LDL-C、HDL-C、hs-CRP and FPG in observation group were significantly improved,only TG、LDL-C and HDL-C in control group were significantly improved,the differences were statistically significant(P<0.05). There were no obvious adverse reactions during treatment. CONCLUSIONS:Based on the conventional treatment,atorvastatin calcium can effectively improve the IMT and blood lipid,blood pressure and blood glucose of patients with MS,with good safety.

Objective To analysis the relationship between of waist-to-height ratio(WHtR) and the non-alcoholic fatty liver disease(NAFLD).Methods A total of 7 896 were selected as observed subjects from the Kailuan Group in 2011-2012 health physical examination.A questionnaire survey,blood biochemical and abdominal ultrasound examination were finished by trained medical staff.According to previous study recommended cut points the observed subjects was divided into two groups:abdominnal obesity group(WHtR≥0.5,n=3 185) and non-abdominnal obesity group(WHtR<0.5,n=479).According to the WHtR and its quartile,the observed subjects was divided into four groups(first(WHtR<0.47),second(0.47≤WHtR<0.51),third(0.51≤WHtR<0.55) and forth(WHtR≥0.55) quartile groups).NAFLD detection rate of the four groups were Compared.Multiple Logistic regression analysis was used to analyze the influencing factors of the NAFLD.Results (1)The detection rate of NAFLD in abdominnal obesity group was higher than that in non-obesity group(62.7% vs.21.5%,P<0.01).Along with increasing WHtR level in the 4 quartile groups,the incidence of NAFLD was progressively increased,being 12.6 %,38.1%,57.5% and 72.5% respectively in the total population.After stratified by gender,15.1%,40.6%,59.6% and 75.0% in male,7.8%,31.5%,48.3% and 63.8% in female.In the same WHtR group,the NAFLD detection rate of male was higher than female,the differences were statistically significant(P<0.01).(2)Multiple logistic regression analysis showed that compared with the first quartile group,the second,third and forth quartile groups had increased risk of NAFLD after adjusting age,gender and other risk factors,the OR value being 3.19,5.93 and 9.81 in the total population.After adjusting above factors,the OR value being 3.12,6.02 and 10.45 in male,3.32,5.37 and 7.57 in female,respectively.Conclusion The incidence of NAFLD is increased along with the increasing the WHtR.

Objective To investigate the effects of waist-to-hip ratio (WHR) on the formation of carotid plaque in the middle-aged and elderly people.Methods A total of five thousand and ninety-nine participants who have taken physical examination in Tangshan Kailuan Company from June 2010 to October 2011(above 40 years old,no previous history of ischemic stroke,transient ischemic attack,myocardial infarction) were enrolled in this study.Questionnaire survey,blood biochemical and carotid artery ultrasound examination were used to examine the subjects.According to WHR,quartile division was used to divide the subjects into four groups.The detection rates of carotid plaque among the 4 groups were compared.Multivariate logistic regression analysis was used to analyze the factors effecting carotid artery plaques.Results (1) The detection rate of carotid artery plaque increased with the increase of WHR,the rates of the first,second,third and fourth group were 20.7% (571/2 753),21.9% (604/2 753),27.5% (758/2 753) and 29.8% (820/2 753) respectively.The difference was statistically significant(P=0.000).(2) Logistic regression model was used to analyze multiple factors affecting the detection rate of carotid plaque.After the correction of other factors,compared with the first group,the carotid artery plaque detection rate in the second,third,fourth group were all increased,the OR values were 1.23(95%CI:1.10~1.54),1.65(95%CI:1.52~2.13),1.67(95%CI:1.54~2.17),respectively.Conclusion The increased WHR in the middle-aged and elderly population may increase the risk of carotid plaque formation.

Objective To explore the value of applying multiple disciplinary team (MDT) in the clinical practice teaching of lymphoma. Methods 5-year program clinical medicine undergraduate students of 2012 were divided into experimental and control group randomly, with 30 cases in each group. The ex-perimental group received MDT in clinical teaching through MDT conference and cases analysis. The control group received conventional teaching mainly by smal class presentation and ward round . The effect of teaching was evaluated by examination and questionnaire. The data were analyzed through t-test and chi-square test by SPSS 20.0 software. Results The results showed the students' scores of the theory knowledge test of two groups were similar to each other, but the scores of discussional topic and clinical cases analysis were higher in experimental group than control group and statistically difference [(16.5 ±2.3)vs. (10.5 ±1.8);(37.5±2.5) vs.(27.5±1.8)], (P=0.000), and the final score of two groups showed statistically difference (93.5± 5.2 vs. 76.0 ±6.2) (P=0.000). Meanwhile, questionnaire survey of satisfaction showed that 27 students of experimental group (90.0%) were interested in this new teaching model, 29 students (96.7%) believed it im-proved understanding and memory to the process of lymphoma diagnosis and treatment, 25 students (83.3%) believed it could improved the ablility to diagnose and differential diagnose lymphoma and expanded their clinical view. 28 students (93.3%) had consolidated clinical thinking, and 26 students (86.7%) improved negotiation with patients. All issues were significantly better than control group (P<0.05). Conclusions The clinical teaching model innovation based on MDT could help medical students use the cross-discipinary interviewing and make optimal treatment plan for patients. It is conducive to the cultivation of their diagnosis, differential diagnosis and clinical thinking ability, which is worthy of promotion in hematological clinical teaching.

Objective To investigate the clinical characteristics, curative effect and prognosis of myeloid sarcoma. Methods The clinical data of 12 patients with MS diagnosed at Xijing Hospital of Air Force Medical University from August 2008 to May 2018 were retrospectively analyzed. Their clinical manifestations, diagnosis, treatment and survival were analyzed. Results Twelve patients were 17 to 62 years old. The initial site included lymph node, external auditory canal, eye, buttock, lung, liver, pancreas, breast,skin, vertebra and its surroundings,and cervix. Among 11 patients with peripheral blood classification, bone marrow aspiration and bone marrow biopsy, 6 cases were isolated MS [one of which developed acute myeloid leukemia (AML)], 1 case was chronic myeloid leukemia in chronic phase, 2 cases were AML-M2, and 1 case was myelodysplastic syndrome (MDS), and 1 case was after aplastic anemia (AA) with no infiltration of bone marrow. Immunohistochemical results showed that LCA(+) (7/7), MPO(+) (12/12), CD43(+) (9/9), lysozyme(+) (5/7), CD3(-) (8/8), CD20(-) (9/9), CD34(+) (5/6), CD117(+) (7/7), and Ki-67(+) 30%-90%. Four patients were examined for bone marrow chromosomes, 2 patients with AML had t (8;21), 1 patient with MDS was 47, XX, +8, del(11)(q21), and 1 patient with CML was t(9;22). Two of the 12 patients were lost to follow-up. Among the 10 patients who were followed up, 6 died and 4 survived, and the median survival time was 21 months (2-27 months). Conclusions AA in stable phase with MS and CML in chronic phase with MS are rarely reported. The clinical manifestations of MS patients are varied, of which the common incidence sites are superficial lymph nodes, the infrequent sites are vertebra and its surrounding areas, and the rare sites are eye, pancreas, lung, liver, etc. The median survival time of MS patient is short and the curative effect is poor.

Colorectal cancer is one of the most common malignant tumors of the digestive system. The incidence of colorectal cancer in China is increasing year by year. Screening for adenomas, precancerous lesions and early cancers can effectively reduce the incidence and mortality of colorectal cancer. Therefore, colorectal cancer screening is particularly important. At present, the colorectal cancer examination is mainly divided into fecal examination and colon structural examination. The fecal examination includes fecal occult blood test, fecal exfoliated cell test and fecal genetic analysis. The colon structural examination includes barium enema, colonoscopy and computed tomography colonography. Colonoscopy is considered as the gold standard for the diagnosis of colorectal cancer. It has the advantage of high accuracy, and can be used to find precancerous lesions and remove them at the same time. However, the screening should be greatly restricted because of its invasive examination, the need for intestinal preparation, obvious discomfort and the high cost of medical treatment. Comparatively, fecal occult blood test is simple, easy, non-invasive, saving manpower and material resources, and is suitable for large population screening. Some scholars in China have begun to pay attention to colorectal cancer screening, and fecal occult blood test is widely used in these screenings.