Objective:To investigate the efficacy of modified urethral dilatation in the treatment of female bladder neck obstruction.Methods:The clinical data of 33 female patients with bladder neck obstruction who underwent modified urethral dilatation in the Third People's Hospital of Qingdao from March 2015 to March 2020 were retrospectively analyzed. Before treatment, physical examination, routine urine examination, International Prostate Symptom Score, ultrasound examination, urodynamic examination and cystourethroscopy were performed to confirm the diagnosis. All patients were treated with α-blocker for more than 3 months, but obvious effect was not obtained. Under local anesthesia, they underwent modified urethral dilatation. After 3 months of treatment, International Prostate Symptom Score and urodynamic examination were performed to determine residual urine volume, the maximum urinary flow rate, and detrusor pressure at the maximum urinary flow rate. The curative effects of modified urethral dilatation were evaluated.Results:After modified urethral dilatation, dysuria was obviously alleviated in 25 patients. Eight patients who had no obvious improvement in dysuria were scheduled to undergo transurethral bladder neck incision. International Prostate Symptom Score after treatment was significantly lower than that before treatment [(15.18 ± 6.19) vs. (24.86 ± 7.26), t = 3.782, P < 0.001). Residual urine volume after treatment was significantly smaller than that before treatment [(53.69 ± 48.35) mL vs. (181.45 ± 92.15) mL, t = 15.328, P < 0.001]. The maximum urinary flow rate after treatment was significantly higher than that before treatment [(16.21 ± 4.22) mL/s vs. (7.91 ± 1.69) mL/s], t = 6.358, P < 0.001]. Detrusor pressure at the maximum urinary flow rate after treatment was significantly lower than that before treatment [(27.38 ± 5.13) cmH 2O vs. (57.15 ± 8.43) cmH 2O, t = 9.584, P < 0.001]. Conclusion:Modified urethral dilatation is an effective treatment method of female bladder neck obstruction. It can be used as a supplement for surgical treatment.

At present, Chinese medical field faces with an important problem of how to correctly handle the relationship between medical and scientific research. Academician Li Lianda advocates doctors doing scientific research under the premise of putting the medical work first. He points out that there are many problems in the process of doctors doing scientific research at present such as paying more attention to scientific research than medical care, excessively promoting building scientific research hospital, only paying attention to training scientific talents, research direction be flashy without substance, the medical evaluation system should be improved and so on. Medical, scientific research and teaching are inseparable because improving medical standards depends on scientific research and personnel training. But not all doctors need to take into account of medical treatment, scientific research and teaching in the same degree while not all hospitals need to turn into three-in-one hospital, scientific research hospital or teaching hospital. It must be treated differently according to the actual situation.
Altitude ; Biomedical Research ; education ; manpower ; trends ; Humans ; Physicians ; psychology ; statistics & numerical data

Objective To observe the effect of comprehensive rehabilitation based on motor control on sensory-ataxic acute Guillain-Barre syndrome. Methods A patient with sensory-ataxic acute Guillain-Barre syndrome was treated with kinesitherapy based on motor control,included proprioceptive neuromuscular facilitation, coordination training, functional training, balance training, as well as sensory stimulation on the end of arms and legs, recumbent cross trainer therapy and cycle therapy for 2 months. Results After treatment, the score of International Cooperative Ataxia Rating Scale (ICARS) decreased 36 points, activities of daily living increased 9 points, Berg Balance Scale increased 9 points, and modified Barthel Index increased 50 points. Conclusion The comprehensive rehabilitation based on motor control is effective on this patient, but more cases and systematic curative effect evaluation are needed.

Humans ; Mouth Diseases ; diagnosis ; therapy ; Orthodontics, Corrective

Humans ; Male ; Middle Aged ; Polycythemia ; etiology ; Sleep Apnea, Obstructive ; complications

Cyclosporine ; pharmacokinetics ; therapeutic use ; Humans ; Treatment Outcome

Objective To investigate the causes,preventive measures and treatment of digestive tract injury during laparoscopic cholecystectomy (LC). Methods From January 2000 to December 2007,totally 21 640 patients underwent LC in our hospital,among them,16 had digestive tract injury including injuries in the stomach and duodenum in 14 patients,in the colon in 1,and in the ileum in 1. Results Among the 16 cases,13 were detected during the operation,and thus laparoscopic repair were performed on 3 of the cases,and conversion to open surgery were carried out for the other 10 for repair of the injured tract (7 cases) or major resection of the stomach and Roux-en-Y anastomosis (3 cases). The other 3 patients were confirmed after LC;they received open surgery for repair of the ileum,colostomy or intra-abdominal cavity drainage. In the 16 cases,one patient died of duodenal leakage complicated with multiple organ dysfunction syndrome in 7 days after the operation;the other 15 patients were cured and discharged from hospital without severe complications. Conclusions Most of the digestive tract injury cases during LC are caused by pericholecystic inflammatory adhesion,which leads to insufficient exposure of the surgical field resulting in the tear or perforation of the digestive tract. Proper treatment in early stage is the key to the prognosis of the patients and prevention of severe complications.

Objective To investigate the therapeutic effect of minimally invasive percutaneous nephrostolithotomy (mPCNL) in treatment of kidney calculi and the influence of renal function.Methods According to the operation method,70 patients with kidney calculi were divided into mPCNL group (38 patients) and percutaneous nephrostolithotomy (PCNL) group (32 patients).The curative effect,serum creatinine (SCr) and blood urea nitrogen (BUN) postoperative 1 month were compared.Results The patients in two groups were successfully for broken calculi.The operation time of stag-horn calculi,retinitis simplex kidney pelvis calculi and kidney calices multiple calculi in PCNL group were significantly shorter than those in mPCNL group [(89.13 ± 13.36) min vs.(112.32 ± 12.41) min,(65.28 ±9.76) min vs.(78.84 ± 12.03) min,(98.97 ± 11.84) min vs.(112.64 ± 10.87) min,P ＜ 0.05].The first stage clearance rate of retinitis simplex kidney pelvis calculi in PCNL group was significantly higher than that in mPCNL group [88.89％(8/9) vs.57.14％(8/14),P ＜ 0.05].But the clearance rate of kidney calices multiple calculi in PCNL group was significantly lower than that in mPCNL group [58.33％(7/12) vs.86.67％(13/15),P＜0.05].The first stage clearance rate of stag-horn calculi in two groups had no significant difference [63.64％(7/11) vs.66.67％ (6/9),P ＞ 0.05].The patients in two groups had no serious complication.The rate of fever after operation in two groups had no significant difference [15.63％ (5/32) vs.10.53％ (4/38),P ＞ 0.05].The level of SCr and BUN in the patients combined with kidney insufficiency in two groups were decreased slightly (P ＞ 0.05).The improvement rate of renal function in two groups had no significant difference (P ＞0.05).Conclusions mPCNL and standard channel PCNL in treatment of kidney calculi can achieve a good first stage clearance rate,and the incidence rate of postoperative complication is lower.mPCNL and standard channel PCNL have no obviously influence on early stage renal function.The operation time of mPCNL is generally longer,but the therapeutic effect of kidney calices multiple calculi is better than standard channel PCNL.

The dynamic level of immunosuppressants such as alpha-fetoprotein(α-FP), gestation associated protein, progesterone, estradiol, chorionic gonadotropin, etc. of peripheral sera and the regulatory mechanism of cellular immunity in the peripartum stages in sows were determined by advanced radioimmunoassay (RIA) and immunochemistry methods in this study. The effects on lymphocyte cultivated in vitro by the immunosuppressants mentioned above were tested by cell culture technology, respectively. The results were as follows: (1) α-FP: The level of α-FP of peripheral sera in the stage of ante-parturition was slightly higher than that of post-parturition in sows, but it didn't show statistical difference. The concentration of α-FP of peripheral sera in conceptus sows had no obvious effect on lymphocyte cultivated in vitro, and it indicated that α-FP was not the major immunosuppressant in the pregnancy of sows. However, the α-FP, whose concentration was equal to that of amniotic fluid, had obvious inhibition on lymphocyte cultivated in vitro. (2) Gestation associated protein: The level of gestation associated protein was maintained highly (100-162 mg/L) in peripheral sera and amniotic fluid in the stage of ante-parturition in sows, then descended gradually after parturition and disappeared step by step 5-10 d after parturition. The gestation associated protein, whose concentration were equal to that of peripheral sera and amniotic fluid, were added to lymphocyte culture in vitro, and the effect on lymphocyte activity was not observed yet. This showed that gestation associated protein was not the major immunosuppressant in the peripartum stage in sows. (3) Estradiol and progesterone: Estradiol or progesterone at the level of sera in pregnant sows, could lower the rate of lymphocyte transformation and the level of cellular immunity. (4) Chorionic gonadotropin: The level of chorionic gonadotropin of peripheral sera in the stage of ante-parturition was slightly higher than that of post-parturition in sows, but it didn't have statistical difference. The chorionic gonadotropin, whose concentration was equal to that of sera, was not yet observed obvious effect on lymphocyte cultivated in vitro. (5) Added the five above-mentioned immunosuppressants to lymphocyte culture in vitro, whose concentration were equal to those of sera in pregnant sows, they could drop the rate of lymphocyte resette formation and lymphocyte transformation, lower the level of cellular immunity and reduce the concentration of IL-2 which synthesized and secreted by lymphocyte in culture remarkably. Their inhibitory intensity of cellular immunity was evidently higher than that of any single immunosuppressant.