Objective To explore the clinical effect of pelvic floor muscle rehabilitation therapy to recover pelvic floor dysfunction.Methods 435 cases of 6-8 weeks postpartum urinary incontinence patients were chosen.The urinary incontinence questionnaire ( ICI-QSF) ,and Female Sexual Function Index questionnaire ( FSFI questionnaire) were used to detect maternal urinary incontinence (UI) investigation,pelvic organ prolapse (POP-Q) degree and quality of sexual life questionnaire.Ⅰ muscle,Ⅱ muscle strength and fatigue, vaginal and the change of dynamic pressure for pelvic floor functional change before and after Pelvic floor rehabilitation were compared.Pelvic floor mus-cle rehabilitation treatment included:imitation bioelectricity stimulus,biofeedback,scene reflection training and Kegel exercises.Results After pelvic floor muscle rehabilitation,pelvic floor function improved significantly,pelvic floor muscle strength increase, decrease fatigue, vaginal dynamic pressure rose significant difference:Electrical values (μV) before treatment (5.6 ±1.8),after treatment(15.1 ±4.6),t =3.6,P <0.05;Vaginal dynamic pressure (cmH2O) before treatment(48.7 ±11.0),after treatment (86.3 ±5.1)cmH2O(t=7.2,P<0.01);Fatigue obvi-ously improved,(P<0.01),the effect of Urinary incontinence treatment is very obvious (t=5.6,P<0.05)and pelvic organ prolapse improved significantly:Before treatment vaginal wall prolapse II degrees 63 people,after treat-ment 14 people,remission rate 82%,and Before treatment uterine prolapse 172 people,after treatment uterine pro-lapse 39 people,the response rate of 77.3% (P <0.01),sexual function improved significantly:before treatment score is (78.00 ±20.45) and after treatment scores is (100.00 ±25.36),t=8.6 (P<0.01).Conclusion Pelvic floor muscle rehabilitation effectively improve postpartum women pelvic floor function,can achieve the purpose of the treatment of urinary incontinence,improve pelvic organ prolapse and the quality of sex life.

Objective To discuss the clinical value of immunofecal occult blood test in screening of colorectal cancer and its precancerous lesions in a large series of health checkup population. Methods Colorectal cancer and its precancerous lesions in 5919 subjects undergoing health checkup in our hospital were screened out by using immunofecal occult blood test from July 2006 to June 2007; positive cases with the test were subjected to colorectal endoscopy or X-ray barium enema examination. Relevant results were analyzed in combination with clinical and pathological data. Results Positive result was obtained in 314 out of the 5919 subjects undergoing health checkup with immunofecal occult blood test; the positive rate was 5.30%. 241 cases(76.75% )of them accepted colorectal endoscopic examination and 23 cases(7.32%) accepted X-ray barium enema examination. The total follow up rate was 84.08% with 50 cases out of contact. After excluding the cases out of cantact, 16 cases of colorectal cancer were found morbidity 2.37‰ including 8(50.00% )cases of Dukes A,7 cases (43.75%)of Dukes B and 1 case of Dukes C (6 .25%).The detection rate of colorectal cancer with postive imunofecal occult blood test was 6.06% (16/264). 94 cases (16.01‰) of adenomatous polyps were found including 55 cases (58.51%) of tubular adenoma, 23 cases (24.47% )of villiform- tubular adenoma and 16 cases(17.02%) of villfform adenoma. Among these cases 55 (58.51%)were solitary and 39(41.49%) multiple. In addition, 6 cases of ulcerative colitis in active phase were found. Altogether 116 (43.94%)of the 264 cases with positive immunofecal blood test and not out of contact were found to have colorectal cancer or its precancerous lesions. Conclusion Immunofecal occult blood test is suitable for screening of colorectal cancer and its precancerous lesions in large series of population. Colorectal cancer and its precancerous lesions may be found in relatively early phase and be eradicated in curable stage, thus to reduce the morbidity and mortality.

Objective To know the state of endemic fluorosis,running state of water improvement project in Jiangsu Province,and to provide a scientific basis for adjusting control measures against the disease.Methods Nine key counties were selected from the endemic fluorosis areas as survey spots in Jiangsu in 2012.Three villages in each spot were selected as survey villages.To known the progress and running conditions of water facilities,water samples were collected to determine the fluorosis level.All children aged 8 to 12 were tested for dental fluorosis at the survey villages.The fluorine content in water was determined with F-selective electrode (WS/T 106-1999).Dental fluorosis was diagnosed byased on the Dean method.Results Twenty-seven villages were investigated,the number of villages that had water quality improved was 26,the rate was 96.30％ (26/27);the number of villages that did not have water quality improved was 1,the rate was 3.70％ (1/27).Among the 26 facilities,21 improved-water facilities ran normally,the rate was 80.77％ (21/26);2 facilities ran with intermittently water supply,the rate was 8.70％ (2/26);3 facilities were scraped,the rate was 11.54％ (3/26).In the villages with normal improved-water facilities and qualified water fluorosis,the total rate of dental fluorosis of children aged 8 to 12 was 22.74％ (380/1 761),the index of dental fluorosis was 0.45.In the villages with abnormal improved-water facilities and excessive water fluorosis,the total rate of dental fluorosis of children aged 8 to 12 was 66.51％ (143/215),the index of dental fluorosis was 1.45.The total rate of dental fluorosis of children aged 8 to 12 was 42.86％ (12/28) in the villages which had not changed water source,the index of dental fluorosis was 0.86.Conclusion Improvement of water decreasing fluorine project in Jiangsu Province has a certain effect on children's dental fluorosis,but some of the water fluorosis projects are scrapped,and excess fluorine water should be taken seriously.

目的观察脑血管病康复治疗的临床疗效。方法将244例急性脑血管病患者随机分成康复治疗组和药物治疗组各122例,药物治疗组给予常规药物治疗,康复治疗组在药物治疗的基础上实施康复治疗,疗程30天。治疗前后分别用简式FMA和改良Barthel指数评定患者的运动功能和日常生活活动能力(ADL)。结果康复治疗组患者运动功能和ADL的改善程度明显好于药物治疗组(P<0.01)。结论急性脑血管病在药物治疗的基础上,早期实施康复治疗可明显提高患者的运动功能和ADL。

ObjectiveTo investigate the correlation between any two of Capsule Endoscopy ScroringIndex (Lewis score),simplified Crohn Disease Activity Index (CDAI) and C-reactive protein (CRP) in small bowel Crohn disease (CD).MethodsA total of 58 consecutive patients with known small bowel CD were enrolled. We evaluated disease activity with Lewis score and simplified CDAI. Correlations among CRP,simplified CDAI and Lewis score were calculated with Spearman's rank order correlation coefficient.The optimal CRP cut-off value was calculated using the ROC curve.ResultsThe Lewis score showed inactive,mild and moderate-severe patients were 13,21 and 24,respectively.CRP of moderate-severe group was significantly higher than that in mild and inactive groups ( P ＜ 0.05 ).The optimal CRP cut-off value that differentiated patients with moderate to severe disease from the others was 13.50 mg/L with sensitivity of 87.5％ and specificity of 82.4％.The area under the ROC curve to analyze the cut-off was 0.849.Lewis score was moderately correlated with CRP (r =0.58,P ＜ 0.01 ),and weakly correlated with the simplified CDAI (r =0.40,P ＜ 0.01 ).ConclusionSerum CRP and the simplified CDAI cannot replace Lewis score for capsule endoscopy in the assessment of disease activity in small bowel CD.However,CRP may be considered as an inflammatory marker for evaluating the moderate to severe capsule endoscopic activity.

Objective:To investigate the iodine content distribution of drinking water in Jiangsu Province.Methods:In 2017, the iodine content in drinking water of residents in townships (streets, hereinafter referred to as townships) of Jiangsu Province was investigated. Administrative villages (neighborhood committees, hereinafter referred to as administrative villages) of Jiangsu Province were selected as units for the investigation of townships with the median water iodine greater than 10 μg/L. Delimitation criteria: the median iodine content of water < 40 μg/L was iodine deficiency area, 40-100 μg/L was suitable iodine area, and > 100 μg/L was high iodine area.Results:A total of 1 285 townships were surveyed in 101 counties (cities, districts) in 13 cities, and the median water iodine in townships was 7.28 μg/L. Among them, there were 875 townships with median water iodine < 10 μg/L, accounting for 68.09%; 315 townships 10-< 40 μg/L, accounting for 24.51%; 56 townships 40-100 μg/L, accounting for 4.36%; 39 townships > 100 μg/L, accounting for 3.04%. The water iodine survey at the administrative village level was conducted in 5 864 administrative villages in 410 townships in 6 cities. Among them, 769 administrative villages with median water iodine < 10 μg/L, accounting for 13.11%; 3 558 administrative villages 10 - < 40 μg/L, accounting for 60.68%; 613 administrative villages 40 - 100 μg/L, accounting for 10.45%; and 924 administrative villages > 100 μg/L, accounting for 15.76%.Conclusion:According to the water iodine, there are iodine deficiency, suitable iodine and high iodine areas in Jiangsu Province, mainly in iodine deficiency areas.

To alleviate the shortage of excellent talents of traditional Chinese medicine (TCM), the State Administration of Traditional Chinese Medicine has decided to cultivate a group of talents with strong theoretical foundation, rich practical experience and exquisite skills who would like to devote themselves to TCM technology research. The national talent training program for inheritance of characteristic TCM technology is a major breakthrough in the history of new China in the cultivation of high-level TCM technology talents. A retrospective analysis was performed on the national talent training program for inheritance of characteristic TCM technology hold in training bases from Beijing, Shanghai, Guangdong Province, Jiangsu Province, Anhui Province, Xinjiang Uygur Autonomous Region, Inner Mongolia Autonomous Region, Heilongjiang Province, Yunnan Province, Sichuan Province, Shaanxi Province and Fujian Province. Based on the completion assessment work of 2014 and 2015 national talent training program for inheritance of characteristic TCM technology, and after knowledge exchange and discussion with the training subjects from 30 provinces and some teaching experts in the field of characteristic TCM technology, this paper summarizes the work of the national talent training program for inheritance of characteristic TCM technology. After trained in bases in China, training subjects' theoretical knowledge and practical skills as well as their comprehensive capacity have been greatly promoted. At the same time, there are also some problems and shortages. For example, characteristic TCM technology in some training bases is not prominent enough, some characteristic TCM technologies are not well inherited, and the affiliations of some training subjects do not pay enough attention to it. All of these problems should be solved and improved in future work.

Objective To evaluate the diagnostic value of virtual touch tissue quantification (VTQ) in the diagnosis of renal allograft fibrosis.Methods The renal allografts of 82 patients with biopsies or nephrectomy were assessed by virtual touch quantification.The renal allograft fibrosis was categorized according to the 2005 updated Banff criteria for a G0～G3 grade.All the results were compared among four groups.Results The mean SWV values in G0～G3 were (2.39 ± 0.31)m/s,(2.45 ± 0.34)m/s,(2.58 ± 0.18) m/s,(3.11 ± 0.40)m/s,respectively.There were no significant differences in the mean SWV value between G0 and G1 group,or between G1 and G2 group(P ＞0.05).There were significant differences in the mean SWV value between G0～G2 and G3 group,or between G0 and G2 group(P ＜0.05).Stiffness of renal allograft was significantly correlated to the mean SWV value (Spearman r =0.671,P ＜0.001).According to the area under the ROC curve,the sensitivity and specificity of SWV (area under ROC curve =0.847,cut-off=2.64 m/s) for grade ≥G2 was 78.9％ and 79.5％ respectively.Conclusions Stiffness measured by VTQ reflects the interstitial fibrosis in renal allograft.VTQ technique might be a new tool to identify patients with chronic allograft injury.

Objective To investigate the expression of apoptotic protease cysteinyl aspartate specific proteinase (caspase-3) in cortex neurons of rats with sepsis.Methods Models of rats with sepsis were established by the cecal ligation and puncture (CLP).Totally 70 cases of 30-day-old male Wistar rats were randomly divided into CLP group (n =50) and control group (n =20).In CLP group,CLP was performed in the rats.Neurobehavioral score was measured in 5 rats at 6,12,24 and 48 h after CLP surgery,respectively.Then,they were killed and their brains were removed.The immunohistochemical staining and Western blot were used to detect the apoptotic protein caspase-3 expression in cortex of rats.Control group did not undergo CLP,and the other treatment was the same as CLP group.Results Neurobehavioral scores at 12,24 and 48 h after CLP surgery were significantly lower than that in the control group(t =3.651,3.773,7.155,all P ＜ 0.05),and the scores were gradually decreased,overall situation of rats was getting worse along with the time.Caspase-3 protein expressed only in trace amounts in rat cerebral cortex in the control group by immunofluorescence analysis,however,its expression was significantly increased at 12 h after CLP surgery.Western blot test showed that caspase-3 protein expression in rat cerebral cortex at 6,12 and 24 h after CLP surgery was significantly higher than those in control group (all P ＜ 0.05).Its expression began to increase at 6 h after CLP surgery,and reached the peak at 12 h,then decreased at 48 h.Conclusion The neurobehavioral scores decreases and the expression of apeptosis protease caspase-3 increases in cortex of rats with sepsis brain injury.

Objective To evaluate the value of quantitative analysis of contrast‐enhanced ultrasonography (CEUS) in differentiating acute rejection(AR) from acute tubular necrosis(ATN) of transplant kidney. Methods Total of 67 kidney recipients were examined with conventional US and CEUS. Biopsies were performed in 37 patients, 26 patients were with AR, 11 with ATN, 30 patients as control group. The hemodynamic parameters (PSV and RI) were measured on infrarenal artery with conventional US, while CEUS quantitative analysis was performed on the cortex, pyramid and interlobar artery by time‐intensity curve (TIC). TIC parameters including rise time (RT ), time to peak (TTP), mean transit time (mTT ) were compared among three groups. In addition, the reproducibility of TIC parameters was evaluated. Results The RI in AR group was significantly higher than that in control group, but there were no significant differences of RI between AR and ATN groups. TIC parameters including RT, TTP were with high reproducibility (ICC> 0 7.5). Compared to the other two groups, the RT and TTP of the pyramid, ΔRTm‐c, and ΔTTPm‐c were significantly longer in AR group, the receiver operating curves (ROC) analysis demonstrated that ΔRTm‐c had the highest accuracy and RI had the lowest accuracy for detecting AR(areas under the curve were 0 7.86, 0 7.56, 0 7.49, 0 7.36 and 0 4.98, respectively). High sensitivity and specificity(78 3.% and 73 5.%, respectively) were shown when using 4 6.2 s as a cutoff point of ΔRTm‐c to diagnose AR. Conclusions Quantitative analysis of CEUS could detected the changes of the microcirculation perfusion in kidney grafts with AR and ATN, which might be superior in the diagnosis of AR compared with conventional US.