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.

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.

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 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.

Objective To optimize the purification technology of total flavonoids from the Tripterospermi Chinensis Herba by macroporous resin. Methods The purification abilities of six kinds of macroporous adsorption resins for total flavonoids from Tripterospermi Chinensis Herba were studied with the adsorption and desorption rates as the index by static adsorption and desorption experiments. The column liquid concentration, adsorption rate, and the loaded amount were studied by using dynamic adsorption experiments. The optimal desorption technology was examined by orthogonal experiment. Results AB-8 macroporous resin was found to have good adsorption and desorption effects. The optimal purification conditions were as follows:the column liquid concentration was 5.285 mg/mL, adsorption rate was 2 BV/h;the loaded amount was 17.62 mg/mL. The sample was eluted by 10%ethanol with 4 BV and 50%ethanol of 5 BV at a flow rate of 4 BV/h. The purity of total flavonoids increased to 61.95% after the purification, and the yield was 87.28%. Conclusion This optimized process was stable, feasible and suitable for separation and purification of total flavonoids from Tripterospermi Chinensis Herba.

Objective To explore the method and effects of operative treatment of superior shoul-der suspensory complex(SSSC)injury.Methods A total of 18 patients with SSSC injury were enrolled. There were six cases of scapular neck fracture combined with comminuted clavicle fracture,five cases of scapular neck fracture combined with acromial fracture,and two cases of comminuted clavicle fracture com-bined with acromial and glenoid fracture.These patients were treated with open reduction and internal fixa-tion.Three patients had acromioclavicular joint dislocation combined with coracoclavicular ligament rupture and they were given hook plate fixation and ligament repair.One patient with scapular neck fracture com-bined with acromioclavicular joint dislocation,and one patient with comminuted clavicle fracture combined with coracoclavicular ligament rupture,were treated with the open reduction,internal fixation and the liga-ment repair.Results All patients were followed up for 3 to 14 months,with an average of 9 months.Ana-tomical reduction and healing were all achieved within 7 to 12 weeks,with an average of 8.6 weeks.Con-clusion Anatomical structure of SSSC is very complex and surgery is given priority to internal fixation, which restores the stability good therapeutic effect.

A case of mandible plasma cell myeloma is reported.Plasma cell myeloma is a monoclonal neoplastic proliferation of plasma cells of bone-marrow derivation,usually multi-centric but jaw bones are rarely involved.The treatment requires precise pathological diagno-sis.The prognosis of solitary jaw bone lesions can be good after treatment.

Objective To compare the applications of half-Fourier acquisition single-shot turbo spin-echo(HASTE)sequence and true fast imaging with steady state precession(True FISP)sequence for the delineation of structures and diseases in several twin pregnancy with comorbidities and to explore the clinical value of two series of fast imaging for MRI of fetus.Methods 27 twin preg-nancy women with comorbidities were imaged with HASTE and True FISP sequences.All images were statistically analyzed in re-spect of imaging qualities and artifacts.MR signs of fetal brain were analysized.Results There were abnormal changes in brains in 7 of 27 cases.Both sequences could demonstrate the structures and lesions of the fatus.Imaging quality scores of HASTE were higher than that of True FISP,but with more respiratory blurring.Conclusion There might be varying abnormalities in central nervous system in twin pregnancy with comorbidities.Combining the demonstration abilities of HASTE and True FISP is needed when de-tecting fetus lesions,especially the brain.

Objective:To analyze the relationship among hypertensive cardiac change,kidney disease and hyperten-sive retinopathy (HRP).Methods:A total of 100 patients with hypertension,who were diagnosed and treated in our hospital from Jan 2012 to Dec 2013,were enrolled,including 90 HRP patients (34 cases of class Ⅰ,49 cases of class Ⅱ,six cases of class Ⅲ and one case of class Ⅳ)and 10 cases with normal fundus (normal control group). Clinical data of all patients were analyzed,left ventricular mass index (LVMI),carotid intima-media thickness (IMT)and glomerular filtration rate (GFR)etc.were measured.Results:Compared with normal control group, there were significant thickening in IMT [(0.62±0.30)mm vs.(0.87±0.16)mm vs.(1.10±0.28)mm]in HRP class Ⅰ+Ⅱ group,class Ⅲ+Ⅳ group,the IMT of class Ⅲ+Ⅳ group was significantly thickened than that of class Ⅰ+Ⅱ group (P <0.01 all);Compared with normal control group,the incidence rates of cardiac dilation (0%vs.12.05% vs.71.43%)and kidney function damage (0% vs.24.10% vs.85.71%)significantly rose in HRP class Ⅰ+Ⅱ group,class Ⅲ+Ⅳ group,the incidence rates of cardiac dilation and kidney function damage in HRP class Ⅲ+Ⅳ group significantly rose than those of class Ⅰ+Ⅱ group (P <0.01 all).Conclusion:Severity of hyper-tension retinopathy is closely related to hypertensive cardiac dilation and kidney function damage.