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 evaluate the effects of different degrees of acute normovolemic hemodilution (ANH) on intrapulmonary shunting, oxygen delivery and consumption during one-lung ventilation(OLV) in dogs. Methods Twelve healthy mongrel dogs weighing 18-22 kg were anesthetized with Ⅳ pentobarbital sodium 20mg.kg-1, scopolamine 0.3 mg and pancuronium 0.2 mg. kg-1 and intubated with a left-sided Carlen' s tube. Correct positioning of the tube was verified by auscultation and by visual inspection after thoracotomy at the end of the experiment. The dogs were mechanically ventilated with 100% oxygen. PET CO2 was maintained between 4.67-6.00 kPa. ECG and rectal temperature were continuously monitored. An intravenous line was established for infusion of Lacted Ringer solution. SwanGanz catheter was inserted via femoral vein on one side for sampling of mixed venous blood and measurement of cardiac output (CO) by hemodilution technique and pulmonary artery pressure (PAP).Femoral artery on the other side was cannulated for measurement of mean arterial pressure(MAP) and arterial blood sampling. The body temperature was maintained between 35℃-39℃ during the experiment.Four degrees of ANH were achieved by blood withdrawal and replacement with an equal volume of gelofusin step by step: HD1 (Hct 35%), HD2 (Hct 25%), HD3 (15%) and HD4(7%-8%). The volume of blood to be removed was based upon the patients' estimated blood volume [EBV = body weight (kg) ×7% ], the beginning Hct(Hct0) and the target Hct (Hctt) V = EBV × (Hct0-Hctt)/Hctav. During each degree of hemodilution(HD) two lungs were ventilated(TLV) first followed by one-lung ventilation(OLV)Each ventilation condition was maintained for at least 15 min, then hemodynamics was measured and blood gas analysis including blood concentration of lactate of both arterial blood and mixed venous blood was performed, then Qs/Qt, oxygen delivery (DO2) and oxygen consumption(VO2) were calculated. Results With increasing hemodilution, MAP, pulmonary vaseular resistance(PVR), mean pulmonary arterialpressure(MPAP), PO2 and DO2 had a tendency to decrease, While oxygen extraction ratio(ERO2 ), blood lactate and Qs/Qt tended to increase. There were DO2-dependent VO2 and anaerobic metabolism during HD3 and HD4. PVR and MPAP increased significantly when one lung was being ventilated before HD and during HD1 and HD2 . During HD3 and HD4 there was little difference in PVR and MPAP between OLV and TLV. Qs/Qt increased by 74% (HD2), 164% (HD3) and 177% (HD4) during OLV. Conclusions The results show that both ANH and OLV can affect Qs/Qt and oxygenation. The degree of ANH should be limited to Hct 25 % during OLV.consumpation

Thirty-one patients with middle ear effusion were evaluated for the presence of chlamydia pneumonia by using polymerase chain reaction (PCR) assay. The presence of chlamydia neumonia was 19. 3% (6/31). The results indicated that PCR assay is a highly sensitive and specific for the detection of chlamydia pneumonia in the middle ear effusion and chlamydia pneumonia may be an aetiological agent of middle ear effusion.

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.