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.

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.

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.

Objective To analyze the prevalence of human papilloma virus(HPV) and the relationship between HPV and vaginal environment in puerperium women.Methods One thousand and twenty-nine cases puerperium women were detected for HPV subtype by using nucleic acid flow-through hybridization.Patients with HPV positive had been considered as observe group and the rest as control.The prenatal infection of HPV of HPV-DNA positive and negative postpartum puerperium women, and the vaginal cleanliness of prenatal and postpartum were analyzed.Results In 1 029 cases puerperium women, the total HPV-DNA positive rate was 10.30％(106/1029) ,and high risk infection rate was 95.65％ (110/115).The rate of HPV positive before pregnant in HPV positive group (46.51％, 40/86) was higher than that in HPV negative group (9.09％, 10/110).There was significant difference of vaginal environment in the two groups (x2 =36.567, P＜0.05).In HPV-DNA positive and negative women during the puerperium vaginal cleaning degree of Ⅰ , Ⅱ ratio prenatal respectively were 56.98％ (49/86) and 76.36％ (84/110), and the difference was significant (x2 =8.317, P ＜0.05).Postpartum to 45.35％ (39/86) and 60.00 (66/110), and the difference was significant (x2 =3.941, P＜0.05).Conclusion The HPV infection of pregnant women are easy to getagain.There is relevance between HPV infection and vaginal environment.

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.

Objective nvestigate the propofol combined with fentanyl anesthesia in orthopedic manual reduction applications.MethodsAugust 2015 to December 2016 in our hospital treated 120 cases of acute long bone closed fracture and ankle, shoulder dislocation and other patients, efficient analysis anesthesia, surgery time, patient recovery time, propofol is added volume and total volume, and detection 3min, 1min, 3min, 5min and waking SpO2, HR, MAP, RR values.Two groups of patients after treatment, were given nursing intervention, such as routine diet guidance, nutrition support, health education.after administration before it is administered.Resultsanesthetic effect experimental group total efficiency is higher, the difference was statistically significant (P<0.05);after simultaneous administration of all patients 1min, 3min, 5min signs were lower than prodrug 3min signs, the difference statistically significant (P<0.05), after clear signs of its former administration 3min with no significant difference;experimental group recovery time, propofol bolus of propofol than with total control were lower, the difference was statistically significant (P<0.05);and the two groups were similar to the operation time, the difference was not statistically significant.ConclusionIn summary, propofol combined with fentanyl anesthesia for patients to take the treatment of orthopedic manual reduction obviously worthy of clinical use.

Objective To study the effect of clopidogrel on different CYP2C19 genotypes and platelet reactivity in acute cerebral infarction patients with antiplatelet aggregation.Methods Four hundred and seventy-four cases of cerebral infarction patients in Beijing Tiantan Hospital Affiliated to Capital Medical University from April 2015 to April 2016 were collected.CYP2C19 genotype was determined,and the genotype was divided into the wild type group,the heterozygous type group and the mutant homozygous group.Platelet aggregation inhibition rate(ADP%) and platelet reactivity index induced by ADP were detected.Patients were divided into clopidogrel resistance group(group CR) and non resistant group according to whether ADP% was less than 30.SPSS 16.0 statistical software was used for statistical analysis,the comparison between groups using independent samples t test,chi square test and multivariate analysis using Logistic regression analysis,when P<0.05 difference was statistically significant.Results Among the 474 patients,204 cases(43.04%) were divided into wild-type group,and 204(43.04%) and 66(13.92%) were divided into the mutant heterozygous group and mutant homozygous group.In Chi square test analysis,clopidogrel resistance group and non resistance group CYP2C19 genotype distribution was significantly different(χ2=6.658,P=0.036).CR group angle(α) values((68.87±5.47)°) and MA((66.77±6.25) mm) were higher than that of CS group ((66.55±6.05)° and (63.30±5.66) mm,t=2.199,3.387,P=0.029,0.001).The multivariate logistic regression analysis showed that OR of angle level was 1.028,95%CI was 0.929-1.137 (P=0.595);OR of Ma level was 1.561,95%CI was 0.785-0.970 (P=0.012).Conclusion The effect of clopidogrel on platelet aggregation in patients with acute cerebral infarction is decreased by CYP2C19 gene mutation.CYP2C19 mutant allele is a risk factor for clopidogrel resistance.Angle (α) value and MA value are the risk factors for the diagnosis of CR in the patients with acute cerebral infarction,and the risk of clopidogrel resistance increased when the patients′ Angle (α) value and the value of MA increased.MA value as a predictor of CR and the screening tool has a certain value.

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.