Objective To investigate the clinical efficacy and mechanism of electrical pudendal nerve stimulation (EPNS) in treating female stress urinary incontinence.Methods Thirty-five female patients with stress urinary incontinence were enrolled from May 2006 to April 2008.The average age was (54.9±9.7) years,the duration of incontinence was (74.1 ±45.6) months,the maximum urethral closure pressure was (63.7± 15.9) cm H2O,functional urethral length was (2.34±0.72) cm and bladder neck mobility was (1.23±0.76) cm.Long acupuncture needles were deeply inserted into four sacral points,which were located by the two edges of the sacrum on a level with the fourth sacral foramina and bilaterally to the tip of the coccyx.The needles were electrified (continuous waves,a frequency of 2.5 Hz,an intensity of 45-55 mA and 60 min once) to stimulate the pudendal nerves.When EPNS was performed,perineal ultrasonographic B-mode movements of the pelvic floor muscles (PFM),M-mode curves indicating the PFM contractions,vaginal pressure (VP) and PFM electromyogram were recorded simultaneously.Results When EPNS was performed correctly,the patient felt strong PFM contractions.Simultaneous records showed:1)B-mode cranio-caudal PFM movements; 2) M-mode PFM movement curves (amplitude:about 1 mm,n=31 ; in the other four patients,the M-mode curves were not obvious) ; 3) a sawtooth curve of VP changes (2.61±1.29 cm H2O,n=34); 4) PFM myoelectric waves (amplitude:23.9±25.3 μV).If during the EPNS process the electric current was stopped or its intensity was reduced or the two lower needles were drawn back 1-2 cm,then the above ultrasonographic PFM movements and VP changes disappeared.In the 35 patients,the ICI-Q-SF score was 12.9±2.9 before treatment and decreased to 3.5±3.3 after 27.5± 11.9 sessions of treatment (P＜0.01).Twenty-five patients with ≥50％ symptom improvement at the end of treatment were followed up for 24-72 months (mean 50),and 19 cases had ≥ 50％ symptom improvement during the period of follow-up,including complete symptoms resolution in 10 cases.Conclusion EPNS can contract the PFMs and simulate PFM training to treat female stress incontinence.

Parenteral nutrition (PN) was given to 40 patients with upper gastric carcinoma after proximal gastrectomies; and full enteral nutrition (EN) was subsequently given when bowels function recovered.The nutritional indicators including serum albumin ( Alb),prealbumin .(PA) and transferring,and immunological indicators including IgA,IgG,IgM,C3,C4 were measured before and 1st,8th day after operation.The data were processed by software SPSS 13.0.The average length of hospital stay was 14 d and the aerofluxus time was (58 ±6)hours.There were no changes in blood biochemistry,hepatic function and renal function pre- and post-operation( P ＞0.05 ).The nutritional and immune indicators except the IgM in 1 st day after operation were decreased significantly ( P ＜ 0.05 ).The immune indicators except the IgG in 8th day after operation were significantly improved in comparison of those before and 1st day after operation ( P ＜ 0.05 ).Post-operative complications occurred in 3 patients including 1 case of subphrenic infection and 2 cases of anastomotic leakage.After proper treatment,all patients recovered well.Combined application of EN and PN may improve nutrition and immune status of patients after proximal gastrectomy.

Ovulatory dysfunction refers to absent ovulation or luteal insufficiency. It is commonly seen in women with irregular menstruation or menstrual cycles, especially in those with oligomenorrhea or amenorrhea. Ovulatory dysfunction is considered the single-most frequent cause of female infertility. Clinically, the two major causes of ovulatory dysfunction are polycystic ovarian syndrome (PCOS) and luteinized unruptured follicle syndrome (LUFS). Acupuncture-moxibustion improves ovulation and helps with infertility. Through a systematic review and analysis on relevant literatures in Chinese Medicine and Acupuncture-moxibustion Databankover the last decade, this paper summarized the characteristics and pattern of acupuncture-moxibustion points for improving ovulation in order to provide an optimal acupuncture-moxibustion protocol in this regard.

Purpose To observe the curative effect of special acupuncture techniques on female urethral syndrome and its relationship with the course of treatment.Method Four abdominal and four sacral empirical points were acupunctured with special techniques and electricity. A difference in curative effect was investigated between different numbers of treatments. Results The clinical cure rate reached 15.2% just after ≤ 10 (7.3 ± 1.3) treatments. The curative effect was significantly better after 20-40 (32.1 ± 5.8) treatments than after ≤ 10 (7.3± 1.3) treatments (χ2 = 10.086, P ＜0.05). The clinical cure rate reached 43.5% in the former. Conclusion Special acupuncture techniques have a good clinical effect on female urethral syndrome. The curative effect improves with an increase in the number of treatments.

Objective To study the effect of nutrition support with somatostatin in patients with gastro- esophagus leakage after proximal gastrectomy. Methods 6 patients with gastro-esophagus leakage after proximal gastrectomy for gastric cancer from July 2004 to September 2009 were enrolled. Then, the patients were treated with improved drainage, parenteral & enteral nutrition and somatostatin. Furthermore, nutrition index and duration of recovery were investigated respectively. All data were analyzed between preoperative and postoperative by student's T-Test.Results 6 patients were cured after non-operation. The average period of in-hospital was 32 days. Compared with the post-leakage day 1 ,the nutrition states were significantly improved when patients recovered( P ＜0. 01 ). Non-complication happened. Conclusion It was an effective way to improve the nutrition state and to promote the gastro-esophagus leakage healing.

Postgraduate administration is faced with new challenge in the affiliated clinical hospital because of the increasing quantity of postgraduates.The paper analyzed the characteristics of postgraduate administration and the status quo of information system construction in the affiliated clinical hospital and proposed the ideas of constructing information system for postgraduate administration from three aspects including system-frame,system-function and system-management.The purpose of the study was to provide reference for improving quality of postgraduate administration.

Improvement of the review of dissertation for doctoral degree is important for the training of qualified doctors.Current practice includes double-blind review and open review.This paper compares and analyses the outcome of the two kinds of reviews and found that double-blind review is more objective that the other(the mean of open review score is 96.39±2.069,the mean of double-blind review score is 85.18±6.635.P=0.001,P＜0.01).In the end some suggestions are proposed to improve the double-blind review system.

The paper analysed the double-blind review result of Ph.D candidates' dissertation at Peking University People's Hospital.Rigor deficiency and inadequate knowledge about the research subjects were identified as the main problems.In the end some suggestions were proposed from two aspects,namely,full-process management of Ph.D training and supervisor-team construction.

Objective To establish and assess the high-birth-weight offspring model of the diabetic rat induced by stueptozotocin,and the long-term metabolic impact of maternal hyperglycemia of those offsprings.Methods Streptozotocin (STZ,25 mg/kg) was given to Wistar rats (G group,n =14) once intraperitoneally to induce maternal hyperglycemia model (blood glucose between 10-20 mmol/L),and there still had a number of rats defined as severe hyperglycemia model group (SG group,n =5).The Control group (C group,n =7) were given the same volume citrate buffer solution.The body weight and blood glucose were recorded,and the lavaging glucose tolerance test (LGTT) was performed by a glucose meter in the gestation.The offsprings were corresponding allocated into 2 groups,and the birth weight were recorded.All the offsprings were observated body weight,blood glucose blood pressure (male rats only),and so on.Results (1) The blood glucose of G group (16.8 ±5.4 mmol/L) and SG group (20.5 ±5.6 mmol/L) were increased significantly as compared with C group (7.0 ± 1.4 mmol/L) 5 days after the model was established (P ＜ 0.01) ; and the average blood glucose of G group (16.6 ± 3.4 mmol/L) and SG group (23.8 ± 1.5 mmol/L) increased too as comparede with C group (5.8 ± 1.1 mmol/L),the difference was significance according to statistics (P ＜ 0.01).(2) According to the LGTT result,which operationed on generation day 4 and day 10,the blood glucose of every time point of G group were increased significantly as compared with C group (P ＜ 0.01).(3) The male and female birth weight of G group was remarkably higher than the C group and the SG group (P ＜ 0.05),and the blood glucose of SG /G/C group was (6.5 ±1.2) mmol/L,(4.1 ± 0.8) mmol/L,(4.1 ± 0.8) mmol/L respectively,according to the statistics results,the difference between SG group and G/C group respectively both remarkable (P ＜ 0.05).(4) The body weight,Lee's index,fat weight,and the fat weight of mass ratio in C group mother rats after lactation presented dressed compared with the SG group (P ＜ 0.05),and so as to the G group compared with the SG group (P ＜ 0.05).(5) In the female offsprings of G group,the birth weight was remarkably increased compared with the C group (P ＜ 0.05) ; the body weight of the female offsprings presented an increased trend compared with the C group since the 12 weeks,but had no statistical significance; there were significant differences of body weight between G group and C group since 15 weeks (P ＜ 0.05),and the trend kept up until 26 weeks; in the male offsprings of G group,the body weight on birth day and 4 weeks had a marked rise compared with the C group (P ＜ 0.05) ; and from then on,the body weight of the male offsprings presented an increased trend compared with the C group,but had no statistical significance until 26 weeks (P＞0.05).(6) In G group,the blood glucose on 30 min and 60 min of LGTT in female offsprings were increased than the C group since 20 weeks (P ＜ 0.05) ; the blood glucose of LGTT (30 min) still had a marked rise until 24 weeks (P ＜ 0.05) ; in G group,the blood glucose on 30 min of LGTT in male offsprings was remarkably incrcascd than the C group since 16 weeks (P ＜0.05) ; the blood glucose of LGTT (30 min) still had a marked rise until 24 weeks (P ＜ 0.05).(7) The blood pressure of male offsprings in G group had a marked rise on 12 weeks compared with the C group (P ＜ 0.05) ; from then on the blood pressure of G group kept up a rise trend until 26 weeks,but had no statistical significance (P ＞0.05).Conclusion The diabetic high-birth-weight rat model could be duplicated with STZ (25 mg/kg) once intrapertoneally on the first day of gestation,which were observed some evidently metabolic changes in weight,glucose tolerance and blood pressure.These results could represent an forward step in the clinical study of human gestational diabetes mellitus and their macrosomia babies,which may suffer some metabolic disease in their later life.

Objective To investigate the expression of proinflammatory cytokine interleukin-17(IL-17) and complement cleavage fragment C5a and the regulation effect of C5a on the expression of IL-17 during renal allograft rejection .Methods The frequency of IL-17+ T cell in peripheral blood and the expression of IL-17 in renal tubular epithelial cells (HK2) after C5a stimulation in renal transplant recipients were measured by flow cytometry and the changes of serum C5a level was detected by ELISA ,respectively .Im-munohistochemistry was applied to detect and compare the expression of IL-17 and the deposition of C5b-9 in normal renal tissues and renal tissues with allograft rejection .The difference of IL-17 expression in HK2 cells before and after the recombinant C5a stimulation was detected by immunocytochemistry .Results Both the percentage of IL-17+ T cells and serum C5a levels were sig-nificantly increased after the allogeneic renal transplantation .Compared with normal renal tissues ,both the deposition of C5b-9 and the IL-17 expression in renal tissues with allograft rejection was remarkably up-regulated ,which showed the positive correlation be-tween them .The expression of IL-17 in HK2 was obviously up-regulated by the recombinant C5a stimulation .Conclusion C5a may positively regulate the expression of IL-17 by tubular epithelial cells during the renal allograft rejection .