Objective To investigate the prevalence of nutritional risk and malnutrition,and the application of nutrition support in hospitalized patients with surgically treated gynecologic malignant tumors.Methods 237 hospitalized patients with malignant tumors receiving surgery in Department of Gynecology of Beijing Hospital from January 1 to December 31,2013 were continuously sampled.Nutritional Risk Screening 2002 (NRS 2002) was performed in the morning the day after admission.NRS 2002 score ≥ 3 was considered indicating nutritional risk.Malnutrition was judged in accordance with NRS 2002.The application of postoperative nutrition support was recorded.Results The nutritional risk screening was applicable in all the patients (100％).The prevalence of malnutrition was 5.1％ (12/237) in the whole study population,9.2％ in the elderly (≥65 years),significantly higher than that in the patients ＜ 65 years (2.7％) (P =0.034).The nutritional risk rate was 21.1％ (50/237),which was 29.9％ in the patients ≥ 65 years and significantly lower in the patients ＜ 65 years (16.0％) (P =0.014).The nutritional risk rate in the patients with ovarian and endometrial cancers was higher the rate in those patients with vaginal and vulvar cancer was lower.47 patients (19.8％)received postoperative nutrition support,all being parenteral nutrition,including total parenteral nutrition in 13 patients (5.5％) and single transfusion (providing two or more than two amongs glucose,fat emulsion,andi amino acids) in 34 (14.3％).Tube feeding was not applied in all the patients.33 cases (66％) in the 50 patients with nutritional risk were supported by parenteral nutrition,while 14 cases (7.5％) in the 187 patients without nutritional risk were supported by parenteral nutrition.Conclusions There is nutritional risk in the patients with gynecology malignant tumors,the rate of which is higher in elderly patents (≥ 65 years) than in the patients of other age groups.Therefore,attention must be paid to ensure adequate postoperative nutrition support in the elderly patients.

Objective The type 1 autoimmune pancreatitis is gradually being recognized, but the type 2 AIP is still very rare in Asia.This paper summarizes the clinical characters of type-2 AIP patients in Peking Union Medical College Hospital.Methods From January 2001 to December 2016,all type 2 AIP hospitalized patients who met the ICDC were included in the study.The clinical data, laboratory results and imaging features of all patients were recorded, verified and follow-up.Results Six patients with type 2 AIP were included in the study.The ratio of men and women was 2/1, with an average age of 38.4 years.67.7% (4/6) patients have UC.37.7% (2/6) of patients were asymptomatic.Three patients were diagnosed by pathology.50% (3/6) of patients showed mass of pancreas, and 50% (3/6) of patients showed pancreatic enlargement.Conclusions The clinical manifestations of the type 2 AIP patients in Peking Union Medical College Hospital are the same as those in foreign countries.

Objective To investigate the efficacy and safety of modified anterior vaginal wall repair in the treatment of anterior vaginal prolapse and cystocele in elderly women.Methods We retrospectively analyzed the clinical value of modified anterior vaginal wall repair in 58 elderly women with stage Ⅱ-Ⅳ anterior vaginal prolapse and cystocele,which were evaluated by pelvic organ prolapse quantitation (POP-Q) system.The modified anterior vaginal wall repair was based on the paravaginal repair as an add-on to a reverse bridge repair and cross stitching of bilateral sutures stemmed from vaginal repair.According to the condition of each patient,other pelvic floor repair,perineal laceration repair,and paraurethral fascia reinforcement might be performed at the same time.The curative effectiveness was subjectively and objectively evaluated in the postoperative follow-up.Results A total of 58 operations were successfully finished.The follow-up time was 6-24 months with an average of (14±8) months.The subjective cure rate was 100％ and the rate of objective cure defined as the top of the vagina above the level of ischial spine was 100％ at 3 months follow-up (n=58).The subjective and objective cure rate was 100％ and 96.6％ (56/58) at 6 months follow-up (n=58),100％ and 94.1％ (32/34) at 12 months follow-up (n=34),91.7％ (11/12) and 91.7％ (11/12) at 24 months follow-up (n=12),respectively.Conclusions The modified anterior vaginal wall repair is safe and effective for anterior vaginal prolapse and cystocele in elderly women.

Objective: To evaluate the outcomes and prognostic factors of myelodysplasia syndrome (MDS) patients who received allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Methods: 165 cases of MDS who underwent allo-HSCT from Jan. 2010 to Mar. 2018 were analyzed retrospectively, focusing on the overall survival (OS) , disease free survival (DFS) , relapse, non-relapse mortality (NRM) and their related risk factors. Results: Of all the 165 cases, 105 were male and 60 were female. The 3-year OS and DFS rate were 72.5% (95%CI 64.9%-80.1%) and 67.4% (95%CI 59.17%-75.63%) , respectively. The 3-year cumulative incidence of relapse and NRM were 12.11% (95%CI 7.03%-18.65%) and 20.44% (95%CI 14.15%-27.56%) , respectively. HCT-comorbidity index (P=0.042, HR=2.094, 95%CI 1.026-4.274) was identified as independent risk factor for OS by the multivariate analysis. Intensive chemotherapy before HSCT or hypomethylation agents treatment had no effects on OS[ (67.0±7.5) %vs (57.7±10.9) %, χ²=0.025, P=0.874]. Conclusions allo-HSCT is a promising means for MDS, and NRM is the major cause of treatment failure. MDS with refractory anemia with excess blasts and secondary acute myeloid leukemia patients may not benefit from intensive chemotherapy or hypomethylation agents treatment before HSCT.

Objective:To explore the therapeutic effects of biofeedback therapy of perineal surface on stress urinary incontinence(SUI) in elderly women.Methods:A total of 87 elderly women with SUI treated at the outpatient clinics of Beijing Hospital and Yunnan First People's Hospital between January 2018 and December 2019 were recruited in this prospective cohort study.All participants were therapeutically divided into the perineal BF group(n=53)and the intravaginal BF group(n=34), based on the voluntary selection.In the intravaginal BF group, 3/34 cases dropped out of the study, and finally in 31 cases the treatment was completed.All patients were treated with biofeedback for 8 weeks with twice treatment per week.The quality of life was assessed by the incontinence impact questionnaire scores.Patients underwent the 1-hour pad-weighing test, pelvic floor muscle assessment and quality of life assessment by incontinence impact questionnaire(ⅡQ-7)scores before and after treatment.The effective rate of treatment, adverse reactions and treatment satisfaction scores were compared between the two groups.Results:The urine leakage and scores of ⅡQ-7 questionnaire were significantly improved after versus before 8 weeks of treatment in the perineal BF group[(4.65±2.33) g vs.(11.02±4.85) g, (7.96±5.11) scores vs.(4.34±2.66) scores, t=8.62 and 4.58, P<0.001], and in the intravaginal BF group[(3.85±1.89) g vs.(12.43±3.96) g, (3.81±1.23) scores vs.(8.29±5.01) scores, t=10.89 and 4.84, P<0.001]. Compared with before treatment, the grading of pelvic floor muscle strength was improved after treatment, but had no significant difference in the perineal BF group(3.93±2.77 vs.2.98±2.10, t=1.99, P=0.056)and in the intravaginal BF group(4.51±3.38 vs.3.07±2.02, t=2.04, P=0.051). There was no significant difference in the urine leakage, grading of pelvic floor muscle strength and scores of ⅡQ-7 questionnaire between two groups( P>0.05). The effective rate of treatment had no significant difference between the perineal and intravaginal BF groups(81.13% or 43/53 vs.83.87% or 26/31, χ2=0.10, P=0.750). The incidences of adverse effects were higher(20.59% or 7/34 vs.1.89% or 1/53, χ2=8.68, P=0.003)and the comfort levels during treatment assessed by visual analog scale(VAS)scores were lower in the intravaginal BF group than in the perineal BF group[(8.11±2.93) scores vs.(9.88±3.84) scores, t=2.95, P=0.004]. The main adverse effects included pain or discomfort, vaginal bleeding and increased vaginal discharge in the intrasvaginal BF treatment group. Conclusions:The perineal BF method is as effective as intravaginal BF in female stress urinary incontinencetreatmentin elderly women, and has fewer adverse effects.