Objective To explore the causes of intrapartum rupture of the scarred uterus and sum up the nursing experience. Methods The clinical data of 11 parturients with intrapartum rupture of scarred uterus were retrospectively analyzed to find out the causes of rupture and the nursing strategies were summarized.Result All of them resovered after rescuing and nursing,who were hospitalized for 3-5d and got labored without accidents.The causes included their histories of uterine-incision delivery,living places, education level and individual constitution.Conclusion The nursing measures including intrapartum health care and education, antenatal examination,close observation through the labor process,enhanced techniques and monitoring of high-risk gravida to avoid rupture of uterus,are vital for the decrease of parturient mortality.

OBJECTIVE:To analyze and compare the congruity between Maria and DDW-J standard and Roussel uclaf causali-ty assessment method(RUCAM)for diagnosing drug-induced liver injury(DILI),and evaluate its application. METHODS:In ret-rospective analysis,the clinical data of 122 patients with DILI with RUCAM ≥3 scores was quantitatively scored by Maria and DDW-J standard,χ2 test was conducted for statistical analysis. RESULTS:Among the 122 cases,120 cases(98.4%)were classi-fied as“likely and possible”by DDW-J standard,which was significantly higher than the 58 cases(47.5%)that classified as“pos-sible”by Maria standard,with statistical significance;and compared with Maria standard,DDW-J standard was more closer to RU-CAM scoring results. CONCLUSIONS:DDW-J standard is superior to Maria standard,and close to RUCAM scoring results for DI-LI;RUCAM is still the DILI diagnostic evaluation system with high accuracy and operability.

Objective To study the volume of total prostate and the volume of its transitional zone in different age groups of elderly men. Methods 213 elderly men of 50 to 79 years of age from a community of Beijing city were divided into 3 groups and studied. The volume of total prostate and the volume of the transitional zone were measured by rectal ultrasonography and the index of the transitional zone was calculated. All the data were evaluated with statistical analysis. Results The number of subjects in the 50～59 age group was 75,in the 60～69 age group 81 and in the 70～79 age group 57.The volume of total prostate was 23.82?8.83,29.16?10.01 and 33.77?11.74 respectively and the transitional zone 1.52?1.19, 3.60?3.66 and 7.25?7.02ml respectively. The index of transitional was 0.10?0.12, 0.13?0.11, 0.20?0.11 respectively. The difference in volume of the total prostate has not been statistically significant whereas the difference in the volume of the transitional zone between the 3 age groups has been significant. Conclusions The volume of total prostate and that of the transitional zone increases with age. The speed of hyperplasia of the transitional zone has been faster than that of the whole prostate.The index of the transitional zone indicates the difference of the whole prostate and the transitional zone in hyperplasia.

Objective To study the prostate volume,prostate weight and the clinical parameters in BPH patients and to investigate the interrelationships between the relevant parameters. Methods The complete data of 80 cases of BPH underwent open surgery were reviewed and analyzed.SPSS software was uesd to make the statistical analysis. Results The volume of surgical specimen has been positively correlated with PV( r=0.872,P

Objective To construct a cDNA subtractive library of genes transactivated by c-terminally truncated middle surface protein of hepatitis B virus(MHBs t) with suppression subtractive hybridization technique for cloning genes associated with transactivation. Methods The mRNA was isolated from HepG2 cells transfected with pcDNA3.1(-)-Mt167 and pcDNA3.1(-) empty vectors, respectively, then cDNA was synthesized. After restriction enzyme Rsa I digestion, small-size cDNAs were obtained. Then tester cDNA was divided into two groups and ligated to the specific adaptor 1 and adaptor 2, respectively. After tester cDNA was hybridized with driver cDNA twice and underwent two times of nested PCR and then was subcloned into T/A plasmid vectors to set up the subtractive library. Amplification of the library was carried out with E. coli strain JM109. The cDNA was sequenced and analyzed in GenBank with Blast search after PCR. Results The subtractive library of genes transactivated by MHBs t was constructed successfully. The amplified library contained 94 positive clones. Colony PCR showed that these clones contained 200-800bp inserts. Sequence analysis was performed in 50 clones,and the full length sequences were obtained with bioinformatics method. 23 coding sequences were obtained in total, which consisted of 19 known and 4 unknown ones.Conclusions The obtained sequences may be target genes transactivated by MHBs t, among which some genes coding proteins may involve in cell cycle regulation, immune response and tumour genesis.

Objectives To review our initial experience with the Ho:YAG laser in treating superficial bladder tumors.Methods Ho:YAG laser was applied for treating 52 cases of bladder tumors which were confirmed by cystoscopy and pathology with totally 87 tumors.All tumors were in stage Ta～T 2 and tumors grade G1～G2.The optical fiber was put into bladder through cystoscopy.Ho:YAG laser was used endoscpically to cut and vaporize bladder tumor and normal bladder mucosa near the tumor.Results Nine of 52 patients were performed under local anesthesia in outpatient.Operation time was apparently short (mean 25 minutes) Histopathology of biopsies showed no cancer cells left.There were no intraoperative complication such as bleeding,perforation and delay complication.Catheter time is very short,about 1～3 days or without catheter at all.None of the ureteral orifice were damaged in seven cases of bladder tumors near the ureteral orifice.Six patients were recrred during our follow-up in 50 patients (12%).Conclusions It has been demonstrated that Ho:YAG laser therapy is provided with advantages of simple procedure,the absence of complication,high patient satisfaction,and ability to be used in the outpatient.It is more convenience than TUR-Bt in tumors in the neck of bladder or apex of bladder.

Objective To study the change of clinical and urodynamic parameters in the patients with lower urinary tract symptom (LUTS) caused by detrusor overactivity (DO). Methods Two hundred and twenty-seven patients with LUTS underwent clinical evaluation from October 2006 to December 2008, including Prostate Volume (PV), International Prostate Symptom Score (IPSS), Peak Flow rate (PF) and Residual Urine (RU) measurement. Pressure flow studies were performed. The detrusor overactivity was recorded to classify the patients into 2 groups, DO group and none DO group. The clinical and urodynamic parameters were compared between the two groups. Results Mean patient age was 70 years (range 52 to 89). According to the urodynamic results, there were 126 patients in DO group and 101 patients in none DO group. The mean patients age was older in DO group than the none DO group(P＜0.05). Adjusted by age, the PV, PF, and RU were no different between the two groups(P>0.05). The mean first sensation of bladder, bladder compliance, cystometric capacity, bladder outlet obstruction parameters, single voiding volume and max detrusor pressure during contraction were different between the two groups(P＜0.05). Conclusions The main risk factors of DO are the ageing and BOO. The non invasive parameters such as PV、 PF、 and RU could not be used to judge DO. The changes of urodynamic parameters caused by DO were hyperaesthesia of bladder、lower bladder compliance、 higher max detrusor pressure and lower max cystometric capacity. This study emphasis the importance of the urodynamic studies in the aged patients with LUTS.

Objective To compare the clinical efficacy of Rivaroxaban and Warfarin in the treatment of lower extremity deep vein thrombosis.Methods From January to December 2015,51 patients of deep vein thrombosis of the lower limb divided into.Warfarin group (21 cases) and Rivaroxaban group (30 cases).The time of each therapy lasted for 3 months or longer.The characteristics and the change of lower limb venous patency rate in two groups of patients were analyzed to evaluate the curative effect.Results Rivaroxaban group had shorter therapy time than Warfarin group.The lower limb venous patency rate in Rivaroxaban group were higher than that in Warfarin group (85.7％ vs.60％,P ＜0.05).Ultrasonography showed partial patency in 5 mixed thrombus patients of Warfarin group,while complete patency in 2 and partial patency in 3 of Rivaroxaban group.Normalized rate in peripheral venous thrombosis patients of Rivaroxaban group were higher than Warfarin group (84％ vs.25 ％ P ＜ 0.001).Conclusions Rivaraxaban is superior to Warfarin in the complete recanalization of DVT,while safe and reliable.

Objective To explore the dosimetric difference between different radiotherapy technologies in the treatment of early peripheral stage non?small ?cell lung cancer ( NSCLC ) . Methods Four?dimensional computed tomography scans and delineation of target volumes and organs at risk ( OARs) were performed in 5 patients pathologically diagnosed with stage T1/T2 peripheral NSCLC who were admitted from 2014 to 2015. Target volumes contained gross tumor volume (GTV), internal target volume (ITV), and planning target volume (PTV). ITV was contoured on the maximum intensity projection images. PTV was defined as ITV plus a 5 mm margin. OARs contained the heart, lung, esophagus, and spinal cord. The Monaco 5. 0 treatment planning system was used to design three plans. The three?dimensional conformal radiotherapy (3DCRT) plan had 11 fields in the diseased lung covering the PTV plus a 0. 2 cm margin. The sliding window intensity?modulated radiotherapy ( SW?IMRT ) plan had 9 fields in the same areas as the 3DCRT plan. The volumetric modulated arc therapy ( VMAT) plan had the gantry rotating 180° around the diseased lung. The evaluation criteria referred to the RTOG 0618 trial. Comparison was made by paired t test. Results The SW?IMRT plan had a significantly better homogeneity index than the 3DCRT plan ( 1. 03 vs. 1. 24,P= 0. 017 ) . Compared with the VMAT plan, the mean monitor units in the 3DCRT plan was significantly reduced by 24. 5%( P=0. 022) . The V30 and V40 of the 3DCRT plan were significantly reduced by 29. 4% and 28. 4%, respectively, compared with the SW?IMRT plan ( P=0. 003,0. 006) and 56. 7%and 59. 7%, respectively, compared with the VMAT plan ( P=0. 041,0. 019) . Conclusions 3DCRT may be an appropriate radiotherapy method for early stage NSCLC.

Objective To study the relationship between the bladder outlet obstruction(BOO)and the area under the curve of detrusor during voiding related parameters. Methods One hundred and thirty-eight patiens with benign prostate hyperplasia(BPH) underwent clinical evaluation, including physical examination, flow rate and post-void residual volume measurement. Pressure flow studies were performed. Mean patient age was 68 years (range 56 to 82). The AG number and the LinPURR were recorded to classify the patients into 3 groups, namely unobstructed, equivocal obstructed and obstructed, as the traditional classification. Two new parameters including the area under the curve of detrusor pressure during voiding(AUCdet) and the area under the curve of detrusor pressure during voiding adjusted for voided volume(AUCdet/Vol) were calculated and compared with the traditional classification using the Linear discriminant analysis. Results According to the traditional classification, there were 33 unobstructed, 32 equivocal and 44 obstructed cases. The AUCdet and AUCder/Vol of the 3 groups were different(P＜0.001). Linear discriminant analysis showed that of the cases, 90. 9%(30/33), 43.8%(14/32) and 70. 5%(31/44) were identically categorized by the traditional and the AUCdet/Vol classifications in the unobstructed, equivocal and obstructed groups, respectively. Conclusions The area under the curve of detrusor pressure during voiding related parameters appear to be good parameters of the BOO in patients with BPH. Further studies are needed to test the reliability and validity of these new parameters.