Objective To investigate the effect of biofeedback electrical stimulation and pelvic floor muscle training on the rehabilitation of pelvic floor muscle after delivery by vaginal delivery.Methods From January 2014 to June 2015,90 cases who received pelvic floor rehabilitation treatment after vaginal delivery in Department of Gynecology and Obstetrics of our hospital were selected as the research subjects.According to whether the patients received pelvic floor rehabilitation training,they were divided into the treatment group and control group,90 cases in each group.The treatment group received biofeedback electrical stimulation,pelvic floor muscle training methods of rehabilitation at 6 weeks postpartum.The control group did not take any measures of rehabilitation.Results 4 months postpartum,the bladder neck mobility,urethral rotation angle of the treatment group were significantly lower than those of the control group (t =6.052,4.400,all P ＜0.05).the vaginal muscles voltage measured values of the treatment group was significantly higher than that of the control group (t =9.524,P ＜ 0.05).4 months postpartum,in the treatment group,vaginal muscle Ⅰ grade in 24.44％,grade Ⅱ in 55.56％ and grade Ⅲ in 17.78％,grade ⅣV in 2.22％;in the control group,the vaginal muscle strength grade Ⅰ in 44.44％,grade Ⅱ in 55.56％;The vaginal muscle distribution in the treatment group was significantly better than the control group (Z =-2.865,P ＜ 0.05).Conclusion After vaginal delivery,maternal postpartum receiving biofeedback electrical stimulation,pelvic floor muscle exercise can significantly promote the recovery of pelvic floor muscle function.

Adult ; Aged ; Breast Neoplasms ; metabolism ; pathology ; Carcinoma, Ductal, Breast ; metabolism ; pathology ; Estrogen Receptor alpha ; metabolism ; Estrogen Receptor beta ; metabolism ; Female ; Fibroma ; metabolism ; Humans ; Lymphatic Metastasis ; Middle Aged ; Receptor, ErbB-2 ; metabolism

AIM: To observe the efficacy of intravitreal injection with ranibizumab combined with laser photocoagulation for macular edema ( ME ) secondary to macular branch retinal vein occlusion( MBRVO) .
METHODS:A retrospective analysis included 33 patients (33 eyes) with ME secondary to MBRVO were taken. All patients received intravitreal injection of 0. 5mg ranibizumab ( 0. 05ml ) at first visit. The continue PRN treatment and laser photocoagulation were based on the visual acuity changes and optical coherence tomography findings. The changes of best corrected visual acuity ( BCVA) , central macular thickness( CMT) , and amplitude density and latency of P1 wave in mfERG were observed before treatment and 6mo after treatment.
RESULTS: Before the treatment, logMAR was 0. 68±0.35, 6mo after treatment was 0. 34±0. 23, BCVA was improved obviously ( P < 0. 01 ), BCVA in 21 patients ( 63.64%) were improved in two rows among all the patients. CMT before treatment was(487. 30±63. 58) μm, after treatment was(238. 84±52. 66) μm(P<0. 01). The amplitude densities of P1 wave in ring 1, ring 2 and ring 3 after treatment were significantly increased(all P<0. 01), and the latencies were decrease ( all P < 0. 05 ). The conjunctival hemorrhage was observed in 2 eyes after treatment.
CONCLUSION: Intravitreal injection with ranibizumab combined with laser photocoagulation for ME secondary to MBRVO can reduce the CMT and improve visual function.

Objective: The purpose of this study was to establish a human lung adenocarcinoma cell line SPC-A-1 BM with high bone metastatic potential and detect the bone metastasis in immunodeficient NIH-BNX mice by using in vivo radionuclide bone imaging technology. Methods: The human lung adenocarcinoma cell line SPC-A-1 was injected into left ventricle of mice to induce bone metastasis. The metastatic lesions in mice were traced by radionuclide bone imaging agent. The lesion was resected and the isolated tumor cells were cultured in vitro to obtain the bone metastatic human lung adenocarcinoma cells. The first passage of bone metastatic human lung adenocarcinoma cells were injected again into mice via vascular system (artery and vein) or transplanted in lung orthotopically. The cells were repeatedly screened for several times. Results: Chromosome analysis showed that the bone metastatic SPC-A-1BM cells detected by radionuclide bone imaging still kept the properties of human origin after several cycles of screening in vivo and in vitro. The influence of 99m Tc-MDP (111 MBq) on the growth of SPC-A-1BM cells was similar with or a little less than X ray film (40 kV, 2 mA, 4 s). The overall sensitivity, specificity and accuracy of radionuclide bone imaging and X-ray film were 97.6%, 73.3%, 94% and 31.3%, 100%, 43%, respectively. Conclusion: The radionuclide bone imaging offers a practical and convenient method for establishing a human lung adenocarcinoma cell line SPC-A-1BM with high bone metastatic potential and detecting the bone metastasis in immunodeficient BNX mice.

Objective To improve the existing folded grid tent and enhance the efficiency of medical support.Methods The simple pulley and handling dolly were developed,and the skeleton rod was strengthened.Results The improved folded grid tent was easy to carry,transport and handle,and the skeleton rod was solid enough.Conclusion The improved folded grid tent is gifted with an enhanced support efficiency and a longer service time.

Objective To study retrospectively the efficacy and complications of different surgery approaches used to treat primary spinal tumors and to discuss the surgical strategy in treating them. Methods 135 patients with primary spinal tumors had been treated between July 1998 and July 2005. The following diagnoses were made based on histopathological findings: multiple myeloma in 25 patients, giant cell tumor in 17, neurofibroma or neurilemmoma in 23, chondrosarcoma in 7, osteoblastoma in 6, aneurysmal bone cyst in 4, lymphoma in 9, eosinophilic granuloma in 6, hemangioma in 15, osteosarcoma in 3, Ewing sarcoma in 5, and other different tumors in 15. Anterior approach and posterior approach was used in 73 cases and 31 cases respectively. Posterolateral approach was used in 13 cases and combination of anterior and posterior approach was used in 18 cases. Results Pain relief was obtained in 126 of the 135 patients(93.3%). Improved neurological function was seen in 86 of 92 patients who had suffered from impaired neurological function. No severe complications were found in the follow-up period. Cerebrospinal fluid leakage was observed in 11 patients, and which was successfully treated using antibiotics therapy and raising the foot of the bed. 3 patients suffered from stress ulcer after operation, but they recovered soon after blood transfusion and anti-acid treatment. Other complications included subcutaneous emphysema (in 3 patients), superficial wound infection (in 3 patients),nerve root injury (in 2 patients), implant loosening (in 2 patients), and neurological morbidity due to surgery (in 1 patient). Conclusion When single or two adjacent vertebrae are involved by spinal tumors such as giant cell tumor and chondrosarcoma, tumor resection should be performed through combination of anterior and posterior approach. Aggressive resection based on the Tomita or WBB staging system is the treatment most likely to achieve long-term local control.

Objective:To analyze the related risk factors for esophageal variceal bleeding(EVB)in patients with hepatocirrhosis and portal hypertension,so as to provide clinical evidences for establishing preventive measures for EVB. Methods:Using"*esophag*","varice*","bleeding","hemorrhage",and"risk factor*"as the key words,we searched the clinical studies(1986-2006)about the risk factors of EVB in hepatocirrhosis patients in PubMed,Medline,Chinese Biomedical Database,Elsevier Database,OVID Database,etc.for Meta-analysis.The odds ratio(OR)of each risk factor was estimated and the 95% confidence interval[95% CI]was calculated.Results:Totally 19 papers met our criteria and were included in this Meta-analysis.The 19 papers involved 995 EVB patients and 1854 controls.Meta-analysis revealed that a hepatic function of Child C,decreased prothrombin activity,hypoalbuminemia,severe esophageal varices,positive red-color sign,extended portal vein width and splenic vein width,thrombopenia,leucopenia and anemia were the risk factors of EVB;a hepatic function of Child A and mild esophageal varices were the protective factors of EVB.The gender,age,hepatic function of Child B,ascites, hepatic encephalopathy,hyperbilirubinemia and midrange esophageal varices were not significantly associated with EVB. Conclusion:Improvement of poor hepatic function,blood coagulation status,hypoalbuminemia and treatment & prevention of severe esophageal varices(by endoscopic variceal ligation,devascularization and shunt)can help to reduce the incidence of EVB.

Objective To investigate the expression of glioma-associated oncogene 2 (Gli2) in giant cell tumor of bone, and analyze the differential expression in the different classification of imaging and pathology and the recurrent diseases, to discuss its role and significance in the pathogenesis and prognosis of giant cell tumor of bone. Methods 46 cases of giant cell tumor of bone who received the primary treatment in Peking University Peopleˊs Hospital during Jan 2009 and Dec 2012 and had the full data of treatment and could be follow-up were collected. Among which there were 40 benign cases and 6 malignant cases. The expression of Gli2 in the different cases of giant cell tumor of bone were detected by immunohistochemistry and real-time PCR, and its effect on the prognosis of giant cell tumor of bone was analyzed. Results Immunohistochemistry revealed positive expression of Gli2 in giant cell tumor of bone. The positive rate of Gli2 in malignant cases was significantly higher than that in benign cases [100.0 % (6/6) vs 55.0 % (22/40), P=0.035], and only found increasing trend but no significant difference among recurrent cases (P=0.204). Results of real-time PCR indicated that Gli2 highly expressed in giant cell tumor of bone, and the increasing trend of expression in different pathological types, different image classifications and recurrent cases, but no statistical different were found (all P>0.05). The expression correlation analysis showed that the expression of Gli2 and PTHrP, and the expression of RANKL and OPG either had a significant correlation (both P< 0.05). Additionally the expression of PTHrP and RANKL had a moderate correlation (P<0.05). Conclusions The expression level of Gli2 is high in giant cell tumor of bone, and Gli2 may be involved in recurrence,metastasis and malignant transformation. Gli2 may effect the osteolytic process of giant cell tumor of bone by the regulation mechanism of Gli2-PTHrP-RANKL pathway.

Objective To investigate technique,effect,complications of limb salvage surgery for malignant tumors of the proximal tibia involving the fibula.Methods Between November 1998 and February 2010,32 patients with malignant tumors of the proximal tibia involving the fibula underwent limb salvage surgery in our institute.There were 21 males and 11 females,aged from 10 to 66 years (average,23.4years).There were 23 cases of osteosarcoma,5 cases of chondrosarcoma,1 case of malignant giant cell tumor,and 3 cases of soft tissue sarcoma.All patients received en bloc resection of tumor including proximal tibia and fibula.During operations,ligation of anterior tibial vessels was performed in 14 patients,anastomosis of posterior tibial vessels in 1 patient,both ligation of anterior tibial vessels and anastomosis or replacement of posterior tibial vessels in 5 patients.The common peroneal nerve was resected in 4 patients,and the deep peroneal nerve was resected in 5 patients.The reconstruction methods included prosthetic replacement in 24 patients,replacement with inactivated autograft-prosthesis composite in 5 patients,and replacement with inactivated autograft in 3 patients.The caput mediale musculi gastrocnemii flap was transferred to reconstruct soft tissue defect in 14 patients,while caput laterale musculi gastrocnemii flap was transferred in 1patient.Results All patients were followed up for 11 to 159 months (average,39.4 months).Local recurrence occurred in 6 patients (18.8％).The overall 5-year survival rate was 51.2％.Fourteen patients died of tumor metastasis,2 survived with tumor,and 16 patients survived without tumor.Variant complications occurred in 15 patients (46.9％).The complications included ischemia of the lower leg in 4 patients,peroneal nerve palsy in 12 patients (permanent palsy in 9 patients and temporary palsy in 3 patients),wound healing problem in 4 patients,deep infection in 1 patient,and periprosthetic fracture in 1 patient.The mean MSTS 93 score was 21.6 points (72％).Conculusion The indications of limb salvage surgery for malignant tumors of the proximal tibia involving the fibula should be restricted.Although complications are encountered frequently,most patients have acceptable postoperative function.

Background and purpose: Alveolar soft part sarcoma (ASPS) is a rare malignant neoplasm characterized by slow growth and indolent behavior, and most of the patients had metastases in diagnoses. This study was to define clinical features and assess prognostic factors of ASTS. Methods: Between January 2003 and December 2008, there were 15 patients with ASTS who received treatment and were followed up in the Department of Orthopedic Ontology of Peking University People's Hospital. We retrospectively analyzed the clinical factors of the disease related to prognosis: gender, age, tumor size, primary tumor site, metastatic sites, local recurrence, the roles of postoperative radiotherapy and postoperative chemotherapy. Resnlts: At a follow-up from 7 to 76 months, only 2 patients had local recurrences after excision, but there was a high incidence of pulmonary metastases. Only 6 patients achieved disease free survival, 5 patients died of metastases or other complications. The five-year overall survival rates was 41.7%, and the median survival time was 42.0 months. Univariate analysis and Cox regression analysis revealed that tumor size, tumor primary site and metastases at diagnoses were prognostic factors, but not gender and age, Conclusion: Alveolar soft part sarcoma is a high grade malignant soft tissue neoplasm with frequent metastases to lung, bone or brain. Tumor size, primary tumor site and metastases at diagnoses are some of the prognostic factors. Chemotherapy or radiotherapy after surgery have no benefit to the survival in our analysis. Further prospective studies are needed to clarify the best strategy for the treatment of ASPS.