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.

Objective To explore the microsurgical treatment of the fourth ventricular tumors. Methods A total of 29 cases of the fourth ventricular tumors were given microsurgical treatment from January 2000 to June 2003 in this hospital. In 5 cases the tumor was located close to the cortex with the superior vermis involvement and the microsurgical operation was performed through the cerebellar vermis. The remaining 24 cases underwent microsurgical resection of tumor through the cerebellomedullary fissure approach. Results A total resection was achieved in 23 cases, and a subtotal resection in 6 cases. Postoperative complications included 2 cases of hemorrhage of the upper digestive tract, 1 case of mutism, 1 case of hematoma of the fourth ventricular, 1 case of epidural hematoma remote from surgical site, and 1 case of irregular breath. Follow-up surveys in 19 cases for 3~12 months (mean, 5.5 months) revealed no tumor recurrence. Conclusions Preoperative proper differentiating characters of tumors, clarifying the position of tumors' basal part, selecting appropriate surgical approach, and understanding microanatomy of the fourth ventricular are the key to successfully complete the procedure.

Recombinase polymerase amplification (RPA) is a novel isothermal DNA amplification technology first re-ported in 2006 by Piepenburg et al.This technology has been shown to typically work at temperatures ranging from 25 to 43℃and can detect products within 5-20 min.RPA technology requires little instrumentation for the nucleic acid amplifi-cation reaction and can be performed not only in PCR tubes , but also in simple devices′such as paper .Combined with probe-based detection methods or lateral flow dipstick assay , it can perform quantitative or visual detection respectively . RPA is a technology that is potentially ideal for point-of-care diagnosis and disease prevention and control ,characterized by high sensitivity, high efficiency, high specificity and user-friendliness.This paper introduces the advantages and develop-ment of RPA technology in reaction conditions and product detection ,summarizes the current applications of this technolo-gy,and predicts the trend of application of RPA technology in point-of-care diagnosis and disease prevention and control .

Objective To investigate the clinical efficacy of laparoscopic splenectomy combined with pericardial devascularization.Methods The retrospective cross-sectional descriptive study was adopted.The clinical data of 64 patients who underwent laparoscopic splenectomy combined with pericardial devascularization at the Second Affiliated Hospital of Kunming Medical University from April 2012 to June 2015 were collected.Observed indexes included (1) treatment outcomes,including surgical procedures,operation time,volume of intraoperative blood loss,time of postoperative enteral recovery,time of postoperative drainage tube removal,duration of postoperative hospital stay,occurrence of complications,(2) follow-up situation.The follow-up using reexaminations of blood routine,liver function,coagulation function,gastroscopy and color Doppler ultrasonography of portal vein was performed regularly at postoperative month 1,2,3,6,12,24 until reemergence of gastrointestinal hemorrhage.The final deadline was death of patients and performance of liver transplantation.Measurement data with normal distribution were presented as-x ± s.Results (1) Treatment outcomes:of 64 patients,62 underwent total laparoscopic splenectomy combined with pericardial devascularization successfully.One patient was transffered to hand-assisted laparoscopic splenectomy combined with pericardial devascularization due to uncontrollable hemorrhage.One patient received laparoscopic cholecystectomy firstly with volume of blood loss of about 1 500 mL and terminated surgery after infusion of suspension red blood cells of 6 U and plasma of 900 mL,and underwent laparoscopic splenectomy combined with pericardial devascularization again next week.No postoperative hemorrhage,pancreatic leakage or death occurred during the perioperative period.The operation time,volume of intraoperative blood loss,time of postoperative enteral recovery,time of postoperative drainage tube removal and duration of postoperative hospital stay were (146 ± 33) minutes,(214 ± 31) mL,(24 ± 4) hours,7 days and (14 ± 6) days,respectively.Nine patients had postoperative pleural effusion and recovered after thoracic drainage and thoracentesis.(2) Follow-up situation:All the 64 patients were followed up for an average time of 19.7 months (range,3.0-23.0 months).Reexamination of gastroscopy showed improvement of varicosed veins of lower esophagus and fundus of stomach.During the postoperative 3 months,4 patients had portal vein thrombosis with level of PLT ＞ 700 × 109/L.For patients with D-Dimer ＞ 5,low molecular weight heparin of 0.4 U was injected subcutaneously until D-Dimer ＜ 2.Three patients were loss to follow-up at postoperative month 6 without upper gastrointestinal hemorrhage,hepatic encephalopathy or liver failure.Conclusion Laparoscopic splenectomy combined with pericardial devascularization is safe and effective for portal hypertension,and rigorous perioperative management offers guarantee for surgical safety.

Objective To study the expression and significance of galanin (GLA) in the prostate carcinoma (PCa).Methods The samples from 50 patients with benign prostatic hyperplasia (BPH) and 50 patients with PCa and 30 PCa patients with bone metastasis were examined by immunohistochemical staining.Results The positive rates of GLA expression in BPH,PCa,and PCa with bone metastasis were 18 ％ (9/50),68 ％ (34/50),and 80 ％ (24/30),respectively,and there were statistically significant differences between PCa patients,PCa patients with bone metastasis and BPH patients (x2 =25.5,29.74,both P ＜ 0.01),but there was no significant difference between PCa patients and PCa patients with bone metastasis (x2 =1.35,P ＞ 0.05).Conclusion GLA has higher expression in prostatic cancer cells,it might be an important indicators for differentiating prostate cancer from benign prostatic hyperplasia and predicting the prognosis of prostate carcinoma.

ction of immune tolerance of T cells to allergens.

Objective To study the state of doctors' psychological capital in public hospitals,and to analyze the characteristics of such capital,so as to better leverage the capital as a hospital management tool.Methods A quantitative and qualitative research was made on the state of doctors＇ psychological capital.Results The doctors' task-oriented psychological capital scored 4.25,and guanxi-oriented psychological capital 4.41; “modesty and prudence”scored the highest in all dimensions of the doctors' psychological capital,“optimism and hope”lowest; the doctors with different genders,ages,seniority,and monthly average income have a difference in psychological capital.However,no significant difference was found with varying titles,hospital levels,and employment models.Conclusion The doctors were found with a strong psychological capital to cope with stress.Better psychological capital will raise quality of care in practice.

Objective To explore the clinical curative effect of laparoscopic cholecystectomy (LC) in treatment of patients with acute calculouscholecystitis in acute stage. Methods We retrospectively analysed the data of 1353 patients with acute calculouscholecystitis in acute stage who received laparoscopic cholecystectomy in Dept.of General Surgery, The First Affiliated Hospital of Nanyang Medical College and Dept.of Hepatopancreatobiliary Surgery 3,The 2nd Affiliated Hospital of Kunming Medical University from August 2008 to December 2012. Results In 1353 patients, 1316 patients were performed LC successfully (97.27%) . One patient was found with bile duct injury and was cured after Laparoscopic T tube drainage. Two patients were found with postoperative bile leakage, one of them was found with wing hole effusion after removal of the abdominal cavity drainage tube, and was cured after continuous drainage. The operation time was 26-168 minutes, with an average of 47 minutes, the hospitalization time was 3-15 days, with an average of 7.3 days. No incision infection was found . 37 patients were transferred to laparotomy because of common bile duct injury in 2 cases, unclear gallbladder triangle in 23 cases, difficult operation after decompression result from high gall bladder pressure caused by big calculus incarceration in the gallbladder neck in 3 cases, gallbladder gallstone disease in 2 cases, atrophic and vitrified acute cholecystitis and biliary calculus in 2 cases, gallbladder artery bleeding in 4 cases and severe abdominal cavity adhesion in 1 case. Conclusion For patients with acute calculous cholecystitis in acute stage, LC is asafe, effective, and minimally invasive treatment method with quick recovery and low cost, but the operator must be familiar with the anatomy of Calot triangle,and has skilled LC operation skills.

The paper analyzed legally the following predicaments of legitimization of rural doctors in China:no legitimacy protection for their practice,vague criteria for practicing medicine,conflicts between legal regulations for medical practice and rural realities,and lack of a liability insurance system.The authors,based on an exploration of the legislative framework for rural doctors,made four corresponding legislative proposals as follows:to clearly define the legal scope and identity of rural doctors,to establish a qualification and employment system for rural doctors,to develop practicing norms applicable for rural doctors,and to set standards for their income.

Objective: To investigate the efficacy of specific point acupuncture and manipulative adjustment on muscle strength of the knee osteoarthritis. Method: One hundred and five patients were randomly allocated to two groups. Sixty-eight cases in the treatment group were treated by specific point acupuncture and manipulative adjustment on muscle strength of the knee joint. While 37 cases in the control group were treated with specific point acupuncture alone. Result: The total effective rate was significantly higher in the treatment group than in the control group (P＜0.05). Conclusion: Specific point acupuncture and manipulative adjustment on muscle strength of the knee joint has a satisfactory curative effect on knee osteoarthritis.