In order to adapt to the development of society,an innovative talent cultivation system has been explored to train stomatological specialists with active innovation spirit and strong ability to practise.

ObjectiveTo investigate the clinical therapeutic effect and safety of solifenacin suceinate in the treatment of overactive bladder symptom after benign prostatic hyperplasia (BPH)operation.MethodsAmong 115 patients receiving BPH surgery,58 cases were given solifenacin at bedtime 4 d after surgery for 20 d (treatment group),and 57 cases were given anisodamine after surgery (control group).The urination of patients before and after pulling out catheter were observed,and urodynamic examination,international prostatic symptoms score (IPSS) and overactive bladder symptom score (OABSS) were used to evaluate urination status.ResultsIn treatment group,IPSS and OABSS decreased from 28.3 to 11.3 score and from (14.2±1.2) to (2.9±0.7) score before and after treatment,respectively (P＜0.01).In control group,IPSS and OABSS decreased from 27.3 to 11.8 score (P＜0.01) and from (14.2±1.6) to (11.3±1.1) score before and after treatment,respectively (P＞0.05).ConclusionsThe proper use of solifenacin after prostate operation may release bladder distress and facilitate rehabilitation in patients with overactive bladder symptom.

This paper analysed the rhinoscope's clinical value in microsurgical treatment of intracranial aneurysms. Application of the rhinoscope in 87 patients, only 2 patients had ruptured during operation. However, 11 cases had ruptured in 94 cases without using rhinoscope, P < 0.05, they had a significant difference. By DSA follow-up review, 82 cases of used rhinoscope only 2 cases had remained the aneurysm neck, but 9 cases had the aneurysm neck in 77 cases which had not used the rhinoscope in the microsurgical treatment, P < 0.05, they also had significant difference. The application of rhinoscope in microsurgical treatment of intracranial aneurysms intraoperative, can reduce the risk of the intraoperative aneurysm rupture. It can achieve better clinical effect.
Adult ; Aged ; Endoscopy ; Female ; Humans ; Intracranial Aneurysm ; surgery ; Male ; Microsurgery ; Middle Aged ; Nose ; surgery ; Treatment Outcome

Objective To study the relationships between patients'personality traits,coping styles, perceived social support and the doctor?patient relationship,try to build the relationship model of patients’ psychological factors and the doctor?patient relationship,and to understand the patients psychological factors influence on the doctor?patient relationship,to provide a basis for improving the doctor?patient relationship. Methods The doctor patient relationship evaluation questionnaire, Eysenck personality questionnaire re?vised,short scale for Chinese( EPQ?RSC) ,simplified coping style questionnaire( SCSQ) and perceived social support scale( PSSS) were used to survey 400 outpatients,using SPSS 22.0 and AMOS 17.0 for data analysis. Results There was statistically significant difference in psychoticism between the high and low doctor?pa?tient relationship evaluation score groups( t=-4.537, P<0.01).There was statistically significant difference in positive coping,family support,friend support,other support and perceived social support between the high and low score groups(P<0.05).Psychoticism had a direct positive effect on doctor?patient relationship( r=0.228, P=0.000) ,and perceived social support had a direct negative effect on the doctor?patient relationship ( r=-0.256, P=0.000).Psychoticism,neuroticism,positive coping and negative coping styles could affect the doctor?patient relationship indirectly by perceived social support. Conclusion Patient personality can affect the doctor?patient relationship directly,meanwhile,it can affect the doctor?patient relationship indirectly by perceived social support,and coping styles can only affect the doctor?patient relationship indirectly by per?ceived social support.

Objective To evaluate the efficacy and safety of laparoscopic technique in the treatment of refractory adhesive intestinal obstruction. Methods In a retrospective matched?pair analysis, 68 patients of re?fractory adhesive intestinal obstruction whose relapsed more than 3 times were included in the research. All patients were treated with laparoscopic operation or continued follow?up observation after conservative treatment from Janu?ary 2011 to January 2016. The patients were divided into 2 groups, laparoscopic surgery (32 cases) and observation group (36 cases), to contrast the recurrence rate and safety of the two types of treatment. Results The recurrence rate of laparoscopic surgery group was significantly lower in the observation group (18.8%vs. 77.8%, P<0.05). Re?fractory adhesive intestinal obstruction is further divided into Mixed type, Patchy adhesion type and Cable Belt Com?pression type, in the laparoscopic surgery subgroup analysis, hybrid recurrence rate (66.7%, 4/6 cases) was signifi?cantly higher than that of patchy adhesion type (10.0%, 1/10 cases) and cord compression type (6.3%, 1/16 cases). Conclusion Laparoscopic operation is safe and feasible in the treatment of refractory adhesive intestinal obstruc?tion, and then it can effectively reduce the recurrence rate of refractory adhesive intestinal obstruction;the curative effect is closely related to the type of adhesion.

Objective To explore the influencing factors of high risk osteoporosis (OP) population. Methods Using multi-stage cluster sampling method, 1 district was selected from each of the 6 cities randomly, then 3 communities were selected from each district randomly. Questionnaire investigation and physical examination were applied to community residents aged 40-69 years old. The questionnaire mainly included basic information, OP risk assessment (using the 1 minute test method developed by the International OP Foundation), health status and lifestyle information (recent 12 months). The relationship between high-risk groups and influencing factors was analyzed by unconditional logistic regression. Results Totally 6577 valid questionnaires were collected, 2069 were male (31.46％) and 4508 were female (68.54％). A total of 166 cases (2.52％) were found as self-reported OP patients at the age of 40-69, self-reported rate of male (1.55％) was lower than that of female (2.97％) (χ2=11.719, P<0.01), the rate was higher among people aged 60-69 years than people aged 40-49 (χ2=44.766, P<0.01);3400 cases (52.28％) were found as high-risk individuals,there were more male at higher risk than female (OR=1.845). Among different age groups, the 50-59 and 60-69 years age groups had more high risk people than that of 40-49 years group (with OR=2.171 and OR=2.854 respectively). Comparative analysis was also conducted for the following factors: degree of education [college or above (OR=0.517) compared with primary school or junior middle school], occupation [compared with civil servants, technical management personnel (OR=2.289), business services (OR=2.224), farming/forestry/fishing (OR=2.258) and production/transportation staff (OR=2.552)], self-reported history of chronic disease (OR=1.596), fracture (OR=4.061), body pain (OR=2.286) and foot cramps (OR=1.923), as well as calcium/vitamin D intake (OR=1.357), increased sunlight (OR=1.256), daily walking steps>5000 (OR=1.336) and BMI>24.00 (OR=1.322), they were all related to a increased proportion of high risk population. Conclusion The proportion of OP high-risk groups is higher among people aged 40-69. Gender, age, cultural level, occupation, bad health status and lifestyle changes are closely related to higher OP risk. Community residents OP screening should be continued to further study the risk factors of OP.

Objective To determine the angles of trochlear line(TL), antero-posterior line (APL) and posterior condylar line (PCL) with clinical epicondylar axis (CEA), analyze the variability difference in 3 axes relative to CEA. Methods The right knees in 36 patients with knee osteoarthritis (gradeⅣ) and who had underwent total knee arthroplasty were enrolled in this study, 11 male patients aged 60-81 (69.1 ± 6.3) years and 25 female patients aged 33- 85(67.7 ± 12.2) years. All of right knees were scanned using computed tomography. The angles between the CEA and each of the 3 axes (TL, PCL, APL) were measured using software. Results The angles of TL-CEA, APL-CEA and PCL-CEA was (6.10 ± 3.22)°, (85.80 ± 2.86)°and (2.70 ± 1.80)°. The F tests showed that the angel invariability between the TL and CEA the APL axis (α=0.58) or the PCL (α=0.28) for referencing the CEA had no significant differences. Conclusions The TL can be a relatively reliable reference axis to determine rotational alignment of the femoral component similar to PCL and APL.

Objective To investigate the mid-and long-term effects of metal-on-metal hip resurfacing arthroplasty (HRA),and to analyze its related factors.Methods A total of 64 patients (81 hips) who underwent metal-on-metal HRA from June 2005 to January 2013 were recruited in the present study.There were 35 males (44 hips) and 29 females (37 hips) with the mean age of 48.26±10.45 years (20-65 years),including 47 unilateral and 17 bilateral HRAs.The cohort consisted of osteoarthritis secondary to the developmental dysplasia of the hip (23 cases,29 hips),necrosis of the femoral head (19 cases,22 hips),osteoarthritis (8 cases,10 hips),rheumatoid arthritis (5 cases,9 hips),ankylosing spondylitis (6 cases,8 hips),pigmented villonodular synovitis (2 cases,2 hips) and Otto's disease (1 case,1 hip).During the follow-up duration,radiographic features,including acetabular inclination angle,stem-femoral shaft angle,component loosening,osteolysis,femoral neck narrowing and heterotopic ossification,were evaluated by hip X-rays in straight and froglike position.The size and type of pseudotumor were assessed by MRI and ultrasonography.Clinical efficacy was evaluated by Harris hip score and the University of California at Los Angeles (UCLA) hip score.Considering revision surgery as the end point,the component survivorship was calculated.Results The mean follow-up was 7.98±2.21 years,ranging from 5.0 to 12.8 years.The mean postoperative Harris hip score (92.01 ±5.69) was higher than the preoperative score (41.93 ±9.09).The mean postoperative UCLA pain,walking,function,activity scores (9.37±0.86,9.14± 1.01,8.77± 1.09,6.47± 1.27,respectively) were improved when compared with the preoperative UCLA scores (3.57± 1.23,5.99± 1.30,5.00± 1.01,3.84± 1.41,respectively).The postoperative flexion,abduction and adduction,medial and lateral rotation of the hip was larger than the preoperative ones.Complications occurred in 10 hips (12.3％,10/81).Seven patients (8 hips) experienced early and intermediate complications,including one intraoperative femoral nerve injury,one deep femoral artery and saphenous nerve injuries during the same surgery,one unexplained pain of hip,one femoral neck fracture,three hips of heterotopic ossification,and one pseudotumour.There were mid-and long-term complications in two hips,including one narrowing of the neck and one pseudotumour which was occurred at 9 years.There was one patient (2 hips) underwent revision surgery twice at 5 months and 9 years.The former cause of revision was femoral neck fracture and the latter one was pseudotumour.The Kaplan-Meier survivorship was 98.8％ at five years,and 95.0％ at ten years.Conclusion Patients who underwent metal-on-metal HRA could obtain good mid and long-term results.Pseudotumour and unexplained pain of the hip are critical factors which can affect the mid-and long-term results and survivorship of metal-on-metal HRA.

Objective:To investigate the effect of free anterolateral thigh perforator flap in repair of forefoot injuries combined with multiple tissue defect.Methods:A retrospective case series study was conducted on 26 patients who suffered from forefoot injuries combined with multiple tissue defect admitted to 920th Hospital of Joint Logistic Support Force of PLA from January 2015 to December 2019. There were 21 males and 5 females, aged 15-61 years [(31.6±12.5)years]. The combined injuries were fracture in 10 patients, arsometatarsal joint dislocation in 3, bone defect in 9, tendon injury in 5, and ligament injury in 3. Management of multiple tissue defect of the forefeet: soft-tissue defect of the forefeet was resurfaced with free anterolateral thigh perforator flaps with the dimension of 6.0 cm×3.5 cm to 26.5 cm×10.0 cm; fracture was fixed by Kirschner wires; joint dislocation was treated by open reduction and Kirschner wires fixations; bone defect was reconstructed either by one-stage bone graft or by use of membrane-induced technique and secondary bone graft, according to the wound conditions; tendon injury of extensor digitorum longus was repaired by direct tendon suture or by tendon transfer; tarsometatarsal ligament injury was primarily sutured. The flap survival rate was observed within 2 weeks after operation. The fracture healing, bone-defect repair, foot appearance, and donor-site healing were detected at 1 month, 3 months, 6 months, 1 year post-operatively and at the last follow-up. The postoperative complications were recorded. The foot function was assessed using American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score before operation and at the final follow-up.Results:All patients were followed up for 6-36 months [(20.5±4.6)months]. All flaps survived uneventfully. The fracture healing and bone defect repair were acquired. The flap showed good texture, including primary flap thinning in 11 patients and secondarily thinning in 15 patients at 3-6 months postoperatively. The donor sites showed good healing, leaving only a linear scar. The flap venous crisis developed in 1 patient and survived after emergency vascular exploring. Local infection of flap occurred in 3 patients and was cured after further debridement and the use of sensitive antibiotics. The AOFAS ankle-hindfoot score was 54-94 points [(76.6±10.4)points] at the last follow-up, compared to preoperative 11-51 points [(27.2±11.3)points] ( P<0.01). The results were excellent in 5 patients, good in 11, and fair in 10, with the excellent and good rate of 62%. Conclusions:For forefoot injuries combined with multiple tissue defect, anterolateral thigh perforator flap transplantation with additional techniques to treat fractures, bone defect, tendon and ligament injuries can achieve satisfactory results in aesthetic appearance of the flap and donor site and foot function recovery.

Objective Toanalyzetheclinicalefficiencyofendovascularinterventionaltherapyinthetreatmentofsolitarykidney withrenalaneurysm.Methods FromJune2014toDecember2017,7casesofsolitarykidneypatientscombinedwithrenalaneurysm werecollected,including4casesofrenalaneurysmlocatedinthemainrenalartery,1caseinrenalsegmentalarteryand2casesinthe renalparenchyma.4casesofmainrenalarteryaneurysmsweretreatedwithstentimplantation;1caseofrenalsegmentalarteryaneurysm was treatedwithstent-assistedcoilembolization;2casesofrenalparenchymaaneurysm wererespectivelytreatedwithpolyvinylalcohol (PVA)embolizationandPVA withcoilembolization.After1month,3months,6monthsandevery6months,therenaldopplerexamination,blood routine,urineroutine,renalfunctionandotherbiochemicalexaminationswerereviewed,andrenalarterialCTAorrenalangiographywereperformed whennecessary.Results Thesuccessrateofoperationwas100%in7solitarykidneypatientswithrenalaneurysm,andtheaneurysmswere graduallyreducedafteroperationwithoutseriousadversereactionsandcomplications.Norecanalizationorrecurrenceofrenalaneurysmwasfound duringthefollow-up,andtherenalfunctionwasbetterthanbefore.Conclusion Endovascularinterventionaltherapyinthetreatment ofsolitarykidneywithrenalaneurysmisminimallyinvasiveandlessrisky.Anditismoretargetedandflexibleforthetreatmentof solitarykidneywithdifferenttypesofrenalaneurysm.