Objectire To investigate female urogenital fistula on the cause,diagnosis and treatment.Methods Thirty nine cases of patients were diagnosed ashaving genitourinary fistula by cystoscopy,intravenous urography,and blue methvlenelest.In 51%of cases were uretero-vaginal fistulas(20/39),one of them were trated byrenal ostomy.17 cases by early emergency ureteroneocystomy,2 cases by ureteralcatheter.In two complex patients with vesico.uretero-vaginal fistula(2/39),the repairwas associated with badder approach vesicovaginal fistula and early emergencyureteroneocystomy.In 44%of cases with vesicovaginal fistula(17/39)were trated bybladder approach after 3～27 months.Results 36 cases of patients were cured after surgery in one time,2 cases of ureteral intubation,1 case of nephrostomy and nephrectomy later with renal infection,1 case of uroclepsia complication.Conclusion Surgical repair of genitourinary fistula will have high rates of success if performed in proper time and appropriate approaches on the basis of patientinf eirmation and urinary fistula pathological type by experienced hands.

Objective To observe the clinical efficacy of hydroxyfasudil in senile heart failure caused by coronary heart disease (CHD). Methods 110 Patients with heart failure caused by CHD were randomly divided into two groups. 55 patients in control group were given conventional treatment, whereas the remaining patients were assigned into hydroxyfasudil group in the base of conventional treatment. After 6 months, we observed and compared the changes in cardiac function of the two groups. Results The effective rate of treatment group was 96.36% and the control group was 85.45%. There was statistical difference between the two groups (P < 0.05). Then we compared the degree of improvement of left ventricular diastolic function using ultrasonic cardiogram and Tei index. Left ventricular ejection fraction of treatment group improved significantly but biochemical indicators of two groups had no statistical difference. Conclusion In patients with heart failure caused by CHD, supplementation of hydroxyfasudil based on conventional therapy could improve diastolic function , potentiate left ventricular remodeling and enhance the life quality. Furthermore, it′s more sensitivity and reasonable to assess cardiac function using Tei index as compared with using ultrasonic cardiogram.

Objective The aim of this study was to explore the establishment method of an animal model of irritable bowel syndrome ( IBS) and the evaluation of this animal model.Methods 30 adult SD rats were randomly divided into two groups: acetic acid irritation and bondage stress group ( n=10 ) , bondage stress group ( n =10 ) , and normal control group ( n=10 ) .The rats of the intervention group received an intra-colonic infusion of 0.4% acetic acid irritation combined with bondage stress to establish an animal model of IBS.The colonic sensitivity of the intervention group rats was assessed by stool test and colorectal distension ( CRD) test.Hydrochloric acid toluidine blue staining was used to observe the number degranulation phenomenon of mast cells in the ileocecum.Results On the 7th day, the number of soft feces was 8 and loose stool was 4 in the model group, significantly higher than that in the bondage stress group(0 and 0) (P<0.05),and normal control group (1 and 0) (P<0.05).On the 10th day, when the AWR=2, the average rectal distension volume was 1.2 mL, significantly lower than that in the bondage stress group(1.37mL) (P <0.05),also significantly lower than in the normal control group (1.49 mL) (P<0.05), and when the AWR=4, the average rectal distension volume was 1.49 mL, significantly lower than that in the bondage stress group(1.74mL) (P<0.05),and the normal control group (1.77 mL) (P<0.05).These results indicated that the visceral sensitivity of the model group was significantly higher than that in the bondage stress group and normal control group.Histological analysis showed that the rats of all groups had no obvious inflammatory changes.Conclusions Chronic bondage stress combined with intra-colonic infusion of 0.4%acetic acid irritation can be used to increase the visceral sensitivity and amount and degranulation of mast cells in the intestinal tissue in rats.This established rat model shows pathogenetic changes resembling the pathogenesis of human irritable bowel syndrome, and provides a useful animal model for further studies of the pathogenesis of this disease.

[Objective] Probing into the effect of Changyanning syrup about colonic electrophysiology and motility of visceral hypersensitivity rat.[Methods] The test consists of the model series and the control series and the Changyanning syrup series,and the two latter rats were sensitized by intraperitoneal injection of chicken egg albumen.After two weeks,the stomach is poured 0.7ml's normal saline by blank space series,0.7ml's normal saline by model series,0.7ml's Changyanning syrup by Changyanning series.Continue to pour stomach in a month,writing colon fast wave,slow wave and the colon contraction,the observation of interdigestive myoelectric complex IMC cycle,Ⅲ times duration,fast wave and slow wave propagation rate,the largesttest amplitude,the amount of the colon contraction,the index of the colon contraction.[Result] The model series' interdigestive myoelectric complex IMC cycle prolongs,Ⅲ times duration prolongs,fast wave and slow wave propagation rate speeds up,the largesttest amplitude broadens.The slow wave propagation rate speeds up.The amount of the colon contraction speeds up,the index of the colon contraction speeds up.After Changyanning series treated,interdigestive myoelectric complex IMC cycle cuts down,Ⅲ times the duration cuts down,the largesttest amplitude decreases.[Conclusion] There are quite differencs between model group and control group in electricity and motion of visceral hypersensitivity rat.Changyanning syrup treating visceral hypersensitivity is by means of partly recovering the colon fast and slow wave and contraction wave rhythm and amplitude.

Both the concept and characteristics of materials circulation management in hospital are expounded.In order to implement materials circulation management in hospital,it is proposed that not only the outside resources should be utilized rationally,but the control of internal materials circulation links should be strengthened,and specially the purchasing and storage management should be highlighted.According to the experience of materials circulation management,it is very necessary to carry on internal materials circulation management in hospital.Any improvement in any link will play a driving role in the improvement of the management level of the hospital.At meantime,the scientific system of internal logistics management should be set up and improved constantly in hospital.

Objective To investigate the prevalence of cervical spondylosis among adults in Beijing.Methods The prevalence of cervical spondyiosis among people older than 18 years who had lived in Beijing for more than six months was investigated in December 2010.The multi-stage sampling was used in this cross-sectional study.The related information was obtained by a self-designed questionnaire.Single and muhivariable Logistic regression models were applied to analyze high risk districts and populations.Results A total of 3859 people were enrolled in this study.Among them there were 531 people with cervical spondylosis,and the prevalence was 13.76％.The prevalence of cervical spondylosis in suburb (15.97％) was the highest compared with city center and countrysides (x2=8.257,P=0.016).The prevalence in females (10.49％) was higher than that (16.51％) in males (x2=29.432,P＜0.001).The distribution of prevalence among different age populations was inverted U shape,and the prevalence was higher in 45 years group (20.43％) and 60 years group (18.91％) compared with other two groups.The prevalence in employed group was 1.303 times higher than that in unemployed group (95％CI:1.008,1.684).According to the muhivariable logistic regression result,suburb (OR=1.306,P=0.026),females (OR=1.81 1,P＜0.001),people who were 45years or 60 years (OR=2.171,P＜0.001; OR=2.430,P＜0.001,respectively) and employed and retired people (OR=1.664,P=0.001; OR=1.303,P=0.043,respectively) were high risk population of cervical spondylosis.Conclusion The prevalence of cervical spondylosis among adults in Beijing was much higher and vastly distributed.It's necessary to reinforce the prevention,diagnosis and treatment study.Young females,people aged 45 years or 60 years,and employed people were high risk populations.

ObjectiveTo explore the protective effects and possible mechanism of different type of proton pump inhibitors (PPIs) in non-steroid anti-inflammatory drugs (NSAIDs)induced small intestinal injury.MethodsSeventy two SD rats were randomly and equally divided into control group,model group,Omeprazole treated group,Esomeprazole treated group,Rabeprazole treated group and Lansoprazole treated group.Except control group,rats of other groups were gavaged with diclofenac 7.5 mg · kg-1 · d-1,once daily to make NSAIDs related small intestinal injury model.The treated groups were gavaged with Omeprazole 30 mg · kg1· d-1,Esomeprazole 30 mg· kg1 · d-l,Lansoprazole 45 mg · kg1 · d-1 and Rabeprazole 15 mg · kg-1 · d-1 once daily respectively.Continuous administration for five days and then executed,small intestinal tissues were taken and observed for gross and pathological changes.The expression level of nuclear factor erythroid-2-related factor 2(Nrf2) at protein and mRNA level were detected with western blot and real time PCR assay.The qualitative and location of Nrf2 in small intestinal tissue were analyzed by immunohistochemistry staining and the activity of superoxide dismutase (SOD) and malondialdehyde (MDA) in small intestinal tissue were determined with xanthine oxidase method and TBA respectively.ResultsThe successful rate of modeling experiment was 100％.The survival ratio of control group rats,model group,Omeprazole treated group,Esomeprazole treated group,Rabeprazole treated group and Lansoprazole treated group was 12/12,3/12,2/12,1/12,1/12 and 2/12 respectively.The tissue injure scores of Esomeprazole treated group,Rabeprazole treated group and Lansoprazole treated group were significantly lower than that of model group (P＜0.05).The activity of SOD in small intestinal of Rabeprazole treated group was obviously higher than that of model group (P＜ 0.05),while the activity of MDA in Rabeprazole and Esomeprazole treated groups were significantly lower than that of model group (P＜0.05).The results of westen blot indicated that the expression of Nrf2in small intestinal tissue was obviously higher in Rabeprazole treated group than in model group (P＜0.05).The real time PCR results suggested that the expression of Nrf2 at mRNA level in small intestinal tissue of Rabeprazole treated group was obviously higher than those of model and control groups (P＜0.05).Conclusions The protection effects of various PPIs are different in NSAIDs related intestinal injury.There is no obvious protection effect of Omeprazole.Rabeprazole may prevent NSAIDs related intestinal injury by up-regulating expression of Nrf2 and promoting its activation.

BACKGROUND:There is no unified method for treatment of intertrochanteric fracture. Previous dynamic hip screw fixation has some shortcomings, and is gradual y replaced by intramedul ary nail fixation. interTan is a compression interlocking intramedul ary nail designed by Smith Nephew in USA according the characteristics of intertrochanteric fracture. Unique design of pressurized screw thread has control able linear pressure. Moreover, it has the stability of Z-effect anti-rotation.
OBJECTIVE:To analyze the clinical therapeutic effects and superiority of interTan compression interlocking intramedul ary nail for intertrochanteric fracture.
METHODS:A total of 60 patients with intertrochanteric fracture undergoing interTan compression interlocking intramedul ary nail in the Department of Orthopedics, Beijing Chaoyang Emergency Rescue Center from January 2011 to December 2012 were enrol ed in the experimental group. A total of 60 patients with intertrochanteric fractures receiving dynamic hip screw fixation in the Department of Orthopedics, Beijing Chaoyang Emergency Rescue Center from January 2009 to December 2010 were enrol ed in the control group.
RESULTS AND CONCLUSION:Peri-operative bleeding volume, postoperative ambulation time, numerical rating scale score, radiographic healing time and weight-bearing time in the experimental group were lower than those of control group. At 3, 6 months and 1 year after fixation, Harris score and hospital for special surgery knee score were higher in the experimental group than in the control group. These data indicated that compared with dynamic hip screw, interTan compression interlocking intramedul ary nail has unique stability due to its design. Internal fixation can reduce operation trauma, promote fracture healing and improve joint function, and exhibit good clinical therapeutic effects for intertrochanteric fractures.

Cultivation of medical students' clinical practice is an important part of higher medical education.At present,the imbalance of teachers structure and the old and single teaching mode and method etc,have had a great impact on the clinical practice of medical students.Only by strengthening the construction of clinical teachers,establishing access and assessment system of clinical teachers,carring out diverse clinical education reform,such as Problem-Based Learning ( PBL )and Case-Based Learning ( CBL ),etc,and fully mobilizing the initiative of students and enthusiasm for learning to reach teaching and learning complement in virtuous circle.can we truly improve the quality of clinical practice.

Objective To analyze the bacterial distribution and resistance of clinical isolates from exacerbation of COPD patients in C and D classification in our emergency department.Methods The sputums were taken to culture and antimicrobial susceptibility test.VITEK-2 compact automicrobe system was used to identify bacteria.Disc diffusion test was used to determine the antimicrobial resistance.Results Of 222 clinical isolates,27.0％ were Gram positive bacteria,73.0％ were Gram negative bacteria.The Gram positive bacteria mainly was Staphylococcus aureus and Streptococcus pneumoniae.The detection rates of methicillin-resistant Staphylococcus aureus (MRSA) were 50.00％.The MRSA were more resistant than methicillin-sensitive Staphylococcus aureus (MSSA),and they were all sensitive to vancomycin,linezolid or tigecycline.The Gram negative bacteria mainly was Pseudomonas aeruginosa,Escherichia coli,Klebsiella spp and Acinetobacter baumannii.Pseudomonas aeruginosa and Acinetobacter baumannii had high resistant rates.The extended spectrum β-lactamases (ESBLs) producing strains in Escherichia coli were higher than in Klebsiella spp,which had multiple drug resistance.Conclusions The bacterial resistance situation is very severely in exacerbation of COPD patients in C and D classification in our emergency department.The first isolating rate was Pseudomonas aeruginosa.Surveillance of bacterial resistance is very important and effective control measures to reduce resistance is very necessary.