Objective To study the effect of finasteride on preventing prostate hyperplasia with acute urinary retention.Methods Totally 626 patients with benign prostatic hyperplasia (BPH) were randomly divided into treatment group (316 cases) and control group (310 cases),followed up for 3 years.The incidence of acute urinary retention and prostate volume changes were analyzed.Results There were 3 cases of acute urinary retention in treatment group (1.0 ％),9 cases in control group (2.9％) (x2 ＝5.37,P＜0.05).In treatment group,the average prostate volume was reduced about 23.6％ compared with before taking the medicine,on the contrary,prostate volume was averagely increased 12.3％ in control group.Conclusions Finasteride can reduce the risk of acute urinary retention by narrowing the prostate volume in patients of benign prostatic hyperplasia.

ObjectiveTo study the feasibility,safety and efficacy of laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy for adult congenital choledochal cyst.MethodA retrospective study was conducted on 7 adult patients with congenital choledochal cyst who received total laparoscopic cyst excision and Roux-en-y hepaticojejunostomy from May 2008 to February 2011 in the Department of General Surgery of Shengjing Hospital,China Medical University.ResultsAll the laparoscopic surgery was successful.The mean operation time was 210 minutes.The average intraoperative blood loss was 80 ml.All patients were out of bed within the first 24 h after surgery.The mean time to first flatus/bowel motion was 2.4 days.Except 1 patient who had small amount of bile leakage,all patients recovered smoothly without any major postoperative complications.The average hospital stay was 8.1 days.No patients suffered from abdominal pain,fever or jaundice during follow-up from 3 to 30 months.ConclusionTotal laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy was a safe,efficacious,and minimally invasive procedure.

OBJECTIVETo observe the clinical efficacy of BO's abdominal acupuncture for obese type-2 diabetes mellitus (T2DM).

METHODSSixty patients of obese T2DM were randomly divided into an acupuncture group and a medication group, 30 cases in each one. Patients in the medication group were treated with basic treatment combined with oral administration of regular antidiabetics, three weeks as one session. Patients in the acupuncture group, based on the medication group, were treated with abdominal acupuncture at Yinqiguiyuan [Zhongwan (CV 12), Xiawan (CV 10), Qihai (CV 6), Guanguan (CV 4)], Fusiguan [Huaroumen (ST 24), Wailing (TE 5)], Tianshu (ST 25), Daheng (SP 15), Qixue (KI 13), etc.; the treatment was given three times per week, 3 weeks as one session. The systolic blood pressure (SBP), diastolic blood pressure (DBP), body weight, waist circumference (WC), hip circumference, body mass index (BI) were observed before and after treatment in the two groups, and fasting plasma glucose (FPG), fasting insulin (FINS), 2-hours postprandial blood glucose by oral glucose tolerance test (OGTT) and insulin, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), HOMA-IR of insulin resistance index were calculated and adverge events were recorded.

RESULTSCompared before the treatment, SBP, WC, body weight, BMI, FPG, OG-TT2hBG, FINS, GTT2h insulin, HOMA-IR, TC and LDL-C in the acupuncture group were all significantly reduced (all P <0. 05), while FPG, OGTT2H insulin and TG were increased in the medication group (all P<0. 05)'. The differences of reducing SBP, WC, FPG, OGTT2H insulin, HOMA-IR, TC, TG and LDL-C were statistically significant between the two groups (all P<0. 05). The total effective rate was 93. 3% (28/30) in the acupuncture group, which was significantly superior to 23. 3% (7/30) in the medication group (P<0. 01).

CONCLUSIONBO's abdominal acupuncture has obvious clinical efficacy for obese type-2 diabetes mellitus, featuring in lowering blood pressure, reducing weight, decreasing blood glucose, im- proving insulin resistance and lowering lipid, which has no adverse effects and is worthy of clinical popularization and application.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Blood Glucose ; metabolism ; Body Mass Index ; Body Weight ; Cholesterol ; blood ; Diabetes Mellitus, Type 2 ; metabolism ; physiopathology ; therapy ; Female ; Humans ; Insulin ; blood ; metabolism ; Lipoproteins, LDL ; blood ; metabolism ; Male ; Middle Aged ; Triglycerides ; blood ; Waist Circumference

ObjectiveThrough the examination of Clostridium difficile (Cd) in the stool of inflammatory bowel disease (IBD) patients to investigate its infection status in IBD patients and the relationship with IBD.MethodsFrom December 2009 to January 2011,a total of 130 diagnosed IBD patients were collected in the Department of Gastroenterology,Ruijin Hospital,Shanghai Jiaotong University School of medicine,including 60 ulcerative colitis (UC) patients and 70 Crohn's disease (CD) patients.At same time.60 irritable bowel syndrome patients and 60 healthy volunteers were collected as control.Stool samples were tested by PCR and Cd toxin A/B test kit (CDTK).SPSS statistical software was used for statistical analysis.ResultsIn 130 enrolled IBD patients,16 cases (12.3％) were Cd infected,of which 10 were UC cases (16.7％) and 6 were CD cases (8.6％).No Cd infection was found positive in control group (x2 =15.779,P=0.000).The infection rate of Cd in the patients of active stage was higher than that in the patients of inactive stage (x2 =10.092,P=0.001).The infection rate of coion-type CD patients was 4/14,which was significantly higher than those of other types CD patients (x2 =13.125,P=0.001).The infection rate of Cd was 4.5％ in mild UC patients,14.3％ in moderate and 6/17 in severe (x2 =6.667,P=0.037) ; the infection rate were 0％ in mild CD patients,4.2％ in moderate and 5/16 in severe.The infection rate increased along with the increase of The disease severity (x2 =13.907,P=0.000).There was no significant difference in the infection rate of Cd between broad-spectrum antibiotics used and not used patients (x2 =1.414,P =0.378), or between patients with broad-spectrum antibioticsused aloneand combinedwith immunosuppressant (x2 =0.330,P=0.962).ConclusionsThere was certain infection rate of Cd in IBD patients,especially the patients in active stage. The infection rate increased along with the increase of the IBD severity.

Objective To describe the preoperative factors of prolonged intensive care unit length of stay after coronary artery bypass grafting. Methods From 1997 to 2009, 1318 patients underwent isolated CABG in our hospital. Retrospective analysis was performed on these cases. Univariate and multivariate analyses for preoperative risk factors were performed. Prolonged length of ICU stay was defined as initial admission to ICU exceeding 72 h. Results The mean age of patients ( 322women and 996 men) was (67.4±9.4) years. Of 1318 patients undergoing isolated CABG from 1997 to 2009, 205 experienced prolonged length of ICU stay. The length of ICU stay was (40.1 ± 22.5 ) hours and ( 122.6 ± 48.7 ) hours separately.Overall in-hospital mortality was higher among these 205 patients ( 13.7% vs. 1.2%, P ＜0.05 ). The overall mortality was 3.1%. In univariate analyses, there were statistically significant differences with respect to the percentage of CPB, total bypass time, cross-clamp time, number of distal anastomoses, use of pressor agent, use of intro-aortic balloon pump,time of ventilation and hospital mortality. The significant risk factors were age, NYHA class Ⅲ/Ⅳ, left ventricular ejection fraction(LVEF) ＜0.40, renal failure, cerebrovascular and/or peripheral vascular disease, chronic obstructive pulmonary disease, recent acute myocardial infarction, prior percutaneous coronary intervention, left main stenosi, three-vessels disease. The variables entered into the multivariate logistic regression were age, NYHA class Ⅲ/Ⅳ, LVEF ＜0.40, renal failure, chronic obstructive pulmonary disease, recent acute myocardial infarction, prior percutaneous coronary intervention, three-vessels disease. According to the outcome of multivariate logistic regression, we can conclude the model of probability forecast and create a new variable named Pre. The area under ROC curve of the new variable Pre was larger than other variables. Conclusion The main risk factors of prolonged ICU length of stay were LVEF ＜ 0.40, recent acute myocardial infarction, renal failure and chronic obstructive pulmorary disease. The AUC of variable Pre was higher than other' s , which indicated that new variable Pre combining each variable was more valuable than single variable with respect to prediction. A predicted probability of 0. 754 was used as cut-off point for the prognostic test.

Objective To analyze the common and individual training needs of palliative care among nurses in different level hospitals. Methods The self-designed questionnaire about training needs of palliative care was used to investigate 340 nurses in different level hospitals. The data were analyzed by Ridit analysis method. Results There were 24 important items and 26 unimportant items in the common training needs. Regarding the individual training needs,the concept of palliative care,basic nursing care and bereavement support were preferred by the primary-level hospital nurzes,while the principles of palliative care,basic nursing care and pain management in secondary-level hospital nurses,radiotherapy and chemotherapy care and the ethical and moral problems in palliative care in third-level hospital nurses. Conclusion Different level hospital nurs-es have beth common and individual needs in the training contents of palliative care. Ridit analysis can distinguish the differ-ences and provide reference for the training.

In recent years, w ith the w idespread use of advanced neuroimaging techniques and the aging of the population, more and more asymptomatic smal unruptured intracranial aneurysms (sUIAs) are incidentaly detected in clinical practice. Studies have show n that the prevalence of unruptured intracranial aneurysm (UIA) is 2%-3% in adults, and more than 2/3 of them are smal aneurysms of < 7 mm in diameter. Usualy these sUIAs do not have any symptoms and the risk of rupture is low er. They are also know n as incidental or asymptomatic aneurysms, but they are not w ithout the risk of rupture. At present, there is no unified opinion about w hether to conduct conservative treatment or surgical clipping or endovascular interventional therapy. This article review s the latest research progress of sUIAs ( < 7 mm in diameter), hoping to provide more evidence for clinical assessment, decision -making, and individual treatment of this kind of aneurysms.

OBJECTIVE:To develop an HPLC method for the determination of Tanshinone Ⅰ,Tanshinone ⅡA,Cryptotanshinone,and Dihydrotanshinone in Shandantong retard tablets.METHODS:The samples were separated on Lichrospher C18 column(250 mm?4.6 mm,5 ?m) with the mobile phase consisted of methanol-water(80∶20).The detection wavelength was set at 270 nm.RESULTS:The linear ranges of Tanshinone Ⅰ,Tanshinone ⅡA,Cryptotanshinone,and Dihydrotanshinone were 0.20～2.00 ?g,0.30～3.00 ?g,0.20～2.00 ?g,and 0.20～2.00 ?g,respectively.The average recoveries were 99.54%,98.89%,100.10%,and 99.44%,respectively with RSD at 0.40%,0.92%,1.30% and 1.53%(n=6),respectively.CONCLUSION:This method is simple,rapid and accurate,and suitable for the quality control of Shandantong retard tablets.

Objective To evaluate the clinical efficacy of Memotherm TM stent,a type of metallic stent in the management of secondary ureteropelvic junction obstruction. Methods From October 1995 to June 2001,13 cases (10 males and 3 females,mean age of 41 years) of secondary ureteropelvic junction obstruction underwent the Memotherm TM stenting.They were all followed up for an average of 26 months by B ultrasound,IVU,radionuclide renography and ureteroscopy. Results Of the 13 case,8 were cured,and 3 achieved improvement,while 2 cases failed.The main complications of endoprosthetic fibrotic stricture occurred in 5 cases.The forceps or YAG laser through ureteroscopy was used to remove the endoprosthetic fibrotic tissues. Conclusions Memotherm TM stent is mostly effective in the treatment of patients with secondary ureteropelvic junction obstruction,especially for patients who has undergone multiple operations or those are ineligible for open surgery.This procedure can significantly reduce the recurrence of ureterostenosis.