Objective To evaluate the efficacy and safety of α1-adrenergic blockers for treating young men with primary bladder neck obstruction (PBNO). Methods A retrospective review was done of the presenting symptoms and videourodynamic findings of 22 young men younger than 35 years with PBNO. Mean age was 28 years (range 18 to 35). The presenting symptoms were hesitancy in 21 (95%), weak stream in 17(77%), frequency in 16(73%), urgency in 8(36%) and pelvic pain in 6 (27%). Mean symptom duration was 28(3-62)months. A dose of 4 mg Doxazosion was adminis-tered for at least 6 months. International prostate symptom score(IPSS), Quality of life(QOL), uro-flowmetry, post-void residual urine and blood pressure were assessed before and 6 months after medi-cation. Improved urine flow was defined as at least 3 ml. per second increase in the maximum flow rate. Improved symptom was defined as more than a 40% decrease in IPSS. Successful treatment was defined as improved in urine flow and symptoms. Results Follow-up data were available for 21 of 22 patients. The medication period was 8.7±2.5 months and follow-up duration was 12.3±4.9 months. Mean Ⅰ-PSS decreased from 16.9±3.7 to 10.7±4.5. Mean QOL decreased from 4.3±1.2 to 2.5±1.0. Mean maximum flow rate increased from (9.8±3.5)ml to (14.9±3.6)ml. per second. Mean post-void residual urine decreased from (78.2±35.6)ml to (46.5±19.4)ml. There were significant differences(P<0.01). Treatment was successful in 14 patients (67%). Drug tolerability was good. Mean blood pressure was (110.0±7.9)/ (75.0±5.9)mm Hg and (107.0±8.7)/(72.0±7.1)mm Hg before medicine therapy and after 6 months medication(P>0.05). Conclusions Videourody-namics is the diagnostic gold standard of PBNO. In our experience α1-adrenergic blockers are clinically effective therapy and safety for PBNO and have been well tolerated in young male patients.

Classification,toxicity and determination method progress especially the pretreatment and limit of quantitation of beauvericin (BEA) and 4 main kinds of enniatins (ENNs) including enniatins A (ENA),enniatins A1 (ENA1),enniatins B (ENB) and enniatins B1 (ENB1) in food were introduced.The contamination levels of BEA,4 kinds of ENNs and their co-occurrence mycotoxins in food from Spain,Morocco,Italy,Japan and some other countries were analyzed.Establishment of high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) determination method for the complex food matrix was suggested.

Objective To analyze the current status and influencing factors of job competence of clinical nursing teachers. Methods A total of 673 clinical nursing teachers from 35 second-level and above hospitals in Anhui Province were selected as research subjects using convenient sampling method. Their job competence was evaluated using the Clinical Nursing Teacher Post Competency Evaluation Scale. Results The score of job competence of clinical nursing teachers was 87.1±9.7. The results of multiple linear regression analysis showed that with the increase of service length and clinical teaching years，the job competence score of clinical nursing teachers increased（all P<0.05）. For those who thought the higher the satisfaction with the teaching atmosphere of the hospital，the hospital teaching training can meet their requirements and the higher the willingness to accept the teaching training，the higher their job competence score（all P<0.05）. Conclusion There is still much room for improvement in job competence of clinical nursing teachers in Anhui Province. The length of service，clinical teaching years， hospital teaching atmosphere，teaching training meeting demand，and willingness to accept clinical teaching training are the influencing factors of job competence of clinical nursing teachers.

Objective To investigate the efficacy and safety of Solifenacin for the treatment of overactive bladder in children. Methods A retrospective analysis was done in a children admitted to our hospital in January 2010,with lower urinary tract obstruction lead to overactive bladder.The boy was 4 years old,suffering from difficult urinating,urinary frequent,urgency and incontinence for 4 years.Imaging studies (B ultrasound,intravenous urography,CT,bladder voiding urethrography) found bilateral hydronephrosis and kidney collecting system separation with left 3.3 cm and right 2.3 cm in diameter; ureteral dilation with left 1.3 cm,right 1.6 cm in diameter.A transverse septum crossing the urethra at a right angle distal to the verumontanum was detected.According to history,physical examination and imaging examination,a diagnosis for posterior urethral valves was established.Under general anesthesia,urethroscopy found that the valve was attached below urethra wall,divided into two forks towards urethral lateral wall.The valve was excised.Three months later,although good voiding,the hydronephrosis and hydroureter still did not improve.After cystostomy and 6 months follow-up,hydronephrosis and hydroureter still not improved. B ultrasound showed the renal pelvis dilation with left 3.2 cm,right 2.0 cm in diameter,and bilateral ureteral dilation with left 1.3 cm,right 1.4 cm in diameter.Solifenacin (5 mg/tablet),1/3 tablet,about 1.7 mg per day was added. Results After oral Solifenacin one month,hydronephrosis and hydroureter began to improve.After 3 months,hydroureter disappeared; hydronephrosis improved significantly.. B-ultrasound showed the renal collecting system mild dilation with left 1.1 cm,right 1.0 cm in diameter.After 13 months follow-up,no side effects was detected. Conclusions Combined with the surgical treatment,Solifenacin can alleviate hydronephrosis secondary to OAB,and can also protect the renal function.

BACKGROUND:Autologous hamstring Rigidfix and Intrafix has been frequently used to fix and reconstruct anterior cruciate ligament. However, it lacks of evaluation of middle and long period of clinical outcomes. OBJECTIVE:To retrospectively evaluate the medium term clinical outcomes of anterior cruciate ligament reconstruction with hamstring tendon autograft by Rigidfix and Intrafix. METHODS:The 39 cases of anterior cruciate ligament injury were subjected to anterior cruciate ligament reconstruction with hamstring tendon autograft by Rigidfix and Intrafix under arthroscope. They were fol owed up for 2 years or more. The clinical outcomes were evaluated using Lyshlom score scale, IKDC2000 and Tegner score scale. RESULTS AND CONCLUSION:In the fol ow-up, IKDC2000 score and Lyshlom score were significantly increased fol owing Rigidfix and Intrafix fixation than before treatment (P<0.01). Results indicate satisfactory clinical outcomes of anterior cruciate ligament reconstruction with hamstring tendon autograft by Rigidfix and Intrafix. However, long-term fol ow up is needed to verify the feasibility of extensive application.

Objective To investigate the CT features of inflammatory myofibroblastic tumor in children. Methods Eighteen patients with inflammatory myofibroblastic tumor proven by surgery and pathology were examined with plain and contrast medium enhancement CT scan. Results Of 18 cases,16 had isolated lesions located at lung (n =4), mesentery (n =3), kidney (n =2) and trachea (n = 1 ),left main bronchus ( n = 1 ), right thoracic cavity ( n = 1 ), peritoneum cavity ( n = 1 ), pancreas ( n = 1 ),left thigh ( n = 1 ), prostate ( n = 1 ), superclvicle soft t tissue ( n = 1 ) , bladder ( n = 1 ). The other 2 cases were with multiple lesions on omentum and mesentery, and in intraperitoneal and side of split of right hepatic lobe, respectively. The CT findings of 18 cases included 16 solid mass with calcifications in 3 of them, and 2 solid-cystic mass. After contrast enhancement, moderate or marked homogeneous or heterogeneous enhancement were shown in all the solid parts of tumor on dynamic CT. Mass can compress surround great vessel and tube-like structure. On pathological examination, the tumor was mainly composed of spindleshaped fibrous cells and inflammatory cells, and the immunohistochemically staining for SMA was observed positively. Conclusion CT can provide specific information for diagnosis of inflammatory myofibroblastic tumor, yet definite diagnosis relies on pathology.

Objective To explore on location of the segments of the facial nerve being easy to damage in mastoid surgery.Methods Retrospective analysis was conducted according to the clinical data of 97cases with chronic suppurative otitis media performed with radical mastoidectomy (or radical mastoidectomy + tympanoplasty) from May 2010 to September 2012,and summarized the methods to locate the segment of the facial nerve being easy to damage in operation.Results ①One case of congenital defect of facial nerve canal was found in 97 cases.②The horizontal segments of the facial nerve of 97 cases were successfully located depending on combined/partial anatomic landmarks including eminence of the lateral semicircular canal,short limb of incus,cochlearform process,tympanic tegmen,stapes.③The pyramidal segment of facial nerve of 97 cases were successfully located depending on combined/partial anatomic landmarks including eminence of the lateral semicircular canal,short limb of incus.④The proximal part of vertical segment of the facial nerve of 97 cases were successfully located depending on combined /partial anatomic landmarks including short limb of incus,chorda tympani nerve,pyramidal eminence,eminence of the lateral semicircular canal.Conclusion The eminence of the lateral semicircular canal,short limb of incus,cochlearform process,tympanic tegmen,stapes,pyramidal eminence,chorda tympani nerve in the area in which the facial nerve being easy to damage are important landmarks by which the segment of facial nerve easy to damage might be located in mastoid surgery.

Objective To investigate the feasibility to reduce radiation doses on pediatric mutidetector abdominal CT using the adaptive statistical iterative reconstruction technique (ASIR) associated with automated tube current modulation technique(ATCM).Methods Thirty patients underwent abdominal CT with ATCM and the follow-up scan with ATCM cooperated with 40％ ASIR.ATCM was used with agedependent noise index (NI) settings: NI =9 for 0-5 year old and NI =11 for ＞ 5 years old for simple ATCM group,NI =11 for 0-5 year old and NI =15 for ＞5 years old for ATCM cooperated with 40％ ASIR group(AISR group).Two radiologists independently evaluated images for diagnostic quality and image noise with subjectively image quality score and image noise score using a 5-point scale.Interobserver agreement was assessed by Kappa test.The volume CT dose indexes (CTDIvol) for the two groups were recorded.Statistical significance for the CTDIvol value was analyzed by pair-sample t test.Results The average CTDIvol for the ASIR group was (1.38 ± 0.64) mGy,about 60％ lower than (3.56 ± 1.23) mGy for the simple ATCM group,and the CTDIvol of two groups had statistically significant differences.(t =33.483,P ＜ 0.05).The subjective image quality scores for the simple ATCM group were 4.43 ± 0.57 and 4.37 ±0.61,Kappa =0.878,P ＜ 0.01 (ASIR group: 4.70 ± 0.47 and 4.60 ± 0.50,Kappa =0.783,P ＜ 0.01),by two observers.The image noise score for the simple ATCM group were 4.03 ±0.56 and 3.83 ±0.53,Kappa =0.572,P ＜ 0.01 (ASIR group: 4.20 ± 0.48 and 4.10 ± 0.48,Kappa =0.748,P ＜ 0.01),by two observers.All images had acceptable diagnostic image quality.Conclusion Lower radiation dose can be achieved by elevating NI with ASIR in pediatric CT abdominal studies,while maintaining diagnostically acceptable images.

Objective : To develop an analytical method of ibotenic acid (IBA) and muscimol (MUS) in wild mushroom by dansyl chloride (DNSCl) derivatization-liquid chromatography-tandem mass spectrometry (LC-MS/MS), and to provide technical support for etiological identification of mushroom poisoning events. Methods : The sample was extracted with hydrochloric acid solution, derived by bimolecular DNSCl, diluted and inorganic salts precipitated with acetonitrile. The extract was separated by a waters XBridgeTM BEH C18 column and measured by LC-MS/MS. Results : The limits of detection for IBA and MUS in wild mushroom were 0.15 mg/kg and 0.1 mg/kg, respectively. Good linear relationship was obtained for IBA and MUS at the range of 0.5-250 mg/kg with the correlation coefficient of 0.997 and 0.999, respectively. The average recoveries at three spiking levels were 84.5%-102.0% with relative standard deviations (RSDs, n=6) of 4.7%-8.6% for IBA. The average recoveries were 88.6%-95.4% with RSDs (n=6) of 4.9%-7.5% for MUS. Conclusion The optimized sample extraction and bimolecular DNSCl derivatization conditions can achieve rapid and accurate analysis of IBA and MUS in wild mushroom poisoning sample.

Objective: To quickly determine bongkrekic acid（BKA）in plasma qualitatively and quantitatively by liquid chromatography-tandem mass spectrometry（LC-MS/MS）,and to provide technical support for etiological identification of food poisoning events. Methods: The plasma sample was protein precipitated with acetonitrile,diluted with water and purified with anion exchange solid phase extraction cartridge of PAX. The sample extract was separated by an XBridgeTM BEH C18 chromatographic column. Gradient elution was conducted with the mobile phase of 0.01 %（v/v）ammonia and methanol. Then BKA was detected by LC-MS/MS. Results: The equation of linear regression was y=16 509x+3 134.3. Good linear relationship was obtained for BKA at a range from 1 to 400 ng/mL in plasma,with the correlation coefficient of 0.999 3. The limit of detection（LOD）was 0.5 ng/mL and the limit of quantitation（LOQ）was 1 ng/mL. The average recoveries were 76.0%-96.7% with relative standard deviations（RSDs,n=6）of 5.2%-12.8% at three spiking levels of 1（LOQ）,10（10 times of LOQ）and 200 ng/mL（medium of linear range）. The concentrations of BKA in plasma obtained from two patients suffering from food poisoning were 394 and 92.3 ng/mL. Conclusion The optimized sample pretreatment and chromatographic separation conditions can achieve rapid,accurate,qualitative and quantitative analysis of BKA in plasma.