Objective To evaluate the effect and safety of transobturator inside-out tension-free urethral suspension (TVT-O) as the surgical treatment on post-operational recurrence of female stress urinary incontinence (SUI). Methods Eleven women with SUI recurrence who underwent TVT-O were selected in the research. Their incontinence recurred from 1 months to 8 years after the previous surgical treatment.Results The operative time was (28 ±9) min, the bleeding volume was (15 ±5) ml. Postoperative complications: urinary retention in 1 case, vaginal erosion in 1 case. Follow-up was enforced for 6-36months, median time was 16 months. Grouts-Blaivas analogue scale:among the 11 patients, 9 patients were cured, 2 patients were improved. ICI-Q-SF score: preoperative 13-21 ( 15.36 ± 2.34) scores compared to postoperative 0-9 (1.46 ±3.27) scores (t =5.850,P ＜0.01 ). I-QOL score: preoperative 23.33-36.67(29.85 ± 4.74) scores compared to postoperative 66.67-100.00 (95.15 ± 10.12) scores (t = 17.753,P ＜0.01 ). PISQ-12 score of 10 patients: preoperative 16-25 (20.10 ± 3.07) scores compared to postoperative 11-20( 14.00 ± 2.83 ) scores (t = 11.600, P ＜ 0.01 ). Conclusion If conservative treatments fail, TVT-O is highly effective and safe for the postoperative recurrent SUI.

Objective: To observe the efficacy of mild moxibustion combined with functional exercise in the treatment of upper-limb lymphedema after breast cancer surgery and its effect on serum vascular endothelial growth factor C (VEGF-C). Methods: Seventy-eight patients were divided into a control group and an observation group by the random number table method, with 39 cases in each group. The control group received functional exercise and the observation group received mild moxibustion plus functional exercise. The differences in circumference between the two upper limbs, the lymphatic flow of the affected upper limb, the disability of arm, shoulder and hand (DASH) score, the functional assessment of cancer therapy-breast (FACT-B) score and serum VEGF-C level between the two groups were compared before and after treatment. Efficacy was evaluated after treatment. Results: The total effective rate was significantly higher in the observation group than in the control group (P<0.05). The difference in circumference between the two upper limbs of the two groups decreased significantly after treatment (both P<0.05), but it was significantly lower in the observation group than in the control group (P<0.05). The lymphatic flow of the affected upper limb of the two groups increased significantly after treatment (both P<0.05), but it was significantly greater in the observation group than in the control group (P<0.05). The DASH scores of the two groups decreased significantly after treatment (both P<0.05), but it was significantly lower in the observation group than in the control group (P<0.05). The FACT-B scores of the two groups increased significantly after treatment (both P<0.05), but it was significantly higher in the observation group than in the control group (P<0.05). After treatment, the serum VEGF-C level increased significantly in the observation group (P<0.05), whereas the control group did not show significant change (P>0.05). The post-treatment serum VEGF-C level was significantly higher in the observation group than in the control group (P<0.05). Conclusion: The efficacy of mild moxibustion combined with functional exercise for upper-limb lymphedema after breast cancer surgery is certain, which can reduce the difference in circumference between the two upper limbs, increase the lymphatic flow of the affected upper limb, improve the limb function and the quality of life, and regulate the serum VEGF-C level.

Objective To compare the isolation rate of Ureaplasma urealyticum(Uu), Mycoplasma hominis(Mh) and Chlamydia trachomatis(CT), and to analyze the resistance of Mh and Uu to 6 kinds of antibiotics. Methods CT in genitourinary tract of 1 059 NGU patients was detected by kit of VIDAS. Uu and Mh in genitourinary tract was detected by kit of IST. Results From 1 059 tested samples, the total positive percentage for Mycoplasma and Chlamydia was 36.3% and 5.6% respectively, 14.8% and 3.7% for Mycoplasma and Chlamydia from male samples, 52.6% and 7.2% for Mycoplasma and Chlamydia from female samples. The colony counting result showed that the number of female samples with colonies more than 104 cfu/ml was greater than that of male samples, 73.2% versus 60.3% for Uu and 30.5% versus 25% for Mh. The sensitivity of Mycoplasma to antimicrobial agents was as follows from high to low: Pristinamycine, Doxycycline, Josamycin, Tetracycline, Ofloxacin, Erythromycin. Conclusions The isolation of Mycoplasma was more than that of Chlamydia from patients with genitourinary tract infection.Resistance monitoring of Mycoplasma periodically played an important role in clinical drug treatment.

Objective To explore the related risk factors for diabetic retinopathy(DR)in type 2diabetes.Methods The clinical data of 412 type 2 diabetes patients,diagnosed between 2003 and 2010,were analyzed retrospectively.The diagnosis of DR and proliferative diabetic retinopathy(PDR)was confirmed by ophthalmoloseopy and fundus fluorescein angiography.Glycated hemoglobin Alc,glucose,insulin,and C-peptide of fasting plasma,and 1,2 and 3 hours postprandial plasma were measured.According to the above-mentioned data,get the fluctuation of glucose,insulin and C-peptide of 1,2 and 3hour postprandial plasma.Results The morbidity of DR and PDR increased following the longer disease duration.Age,diabetic duration,body mass index(BMI),hypertension grade,HbAlC,fasting plasma insulin and C-peptide,2 and 3 hours postprandial plasma glucose,1 and 2 hours postprandial plasma insulin,1,2 and 3 hour postprandial plasma C-peptide,1,2 and 3 hours postprandial plasma glucose,insulin and C-peptide fluctuation are different statistically among non-DR group,non-PDR group and PDR group(P＜0.05).3 hours postprandial plasma glucose and fasting plasma insulin were risk factors of DR (P＜0.05).Conclusions Postprandial plasma glucose and fasting plasma insulin were risk factors of DR.Nevertheless,postprandial insulin,fasting and postprandial C-peptide,postprandial plasma glucose,insulin and C-peptide fluctuation were useful for DR diagnosis.

Objective To assess the radiofrequency ablation (RFA) lesions in canine prostate with real-time harmonic gray-scale contrast-enhanced ultrasonography and investigate the feasibility to predict these lesions.Methods A total of 5 male beagle dogs took RFA of the prostate.Radiofrequency (RF) was delivered under transrectal ultrasound (TRUS) guidance.A lesion was created in the right and left lateral lobes of canine prostate,respectively.The examination of conventional gray-scale ultrasonography,power Doppler ultrasonography,real-time harmonic gray-scale contrast-enhanced ultrasonography were performed immediately after RF procedure.All animals were subsequently sacrificed and the prostates were harvested for pathologic analysis.Thermal lesion volume was calculated based on expected shape of ellipsoid using equation.The volumes of the calculated thermal lesion on contrast-enhanced ultrasonography in dogs were compared with the volumes obtained from the pathological specimens.Results The RFA lesions could not be imaged accurately with real-time conventional gray-scale or power Doppler ultrasonography.However,contrast-enhanced low MI perfusion imaging was able to have real-time monitoring for the lesion (no blood flow).The volume of lesions was measured with contrast-enhanced ultrasonography without significant difference with those of pathologic results.Ultrasonic imaging(conventional gray-scale or power Doppler sonography)of the ablation areas also had its own characteristics.Conclusion The real-time harmonic gray-scale contrast-enhanced ultrasonography appears to be an accurate modality for assessment of RFA lesions.Conventional gray-scale and power Doppler sonography had their own characteristics to evaluate the RFA lesion.

The maxillary first premolar is a transitional tooth between incisors and molars. Most maxillary first premolars have 2 root canals. However, the bilateral maxillary first premolar with 3 roots and 3 canals has not been described. This article reports a rare case:The bilateral maxillary first premolar with 3 roots and 3 canals.

Objective To explore and evaluate the total oxidative and antioxidant status and lipid levels in patients with COPD. Methods Measurement and comparative analysis were preformed between 51 cases of COPD patients and 45 healthy people in serum TOS,TAS,IMA concentration,blood lipid,and the concentration of ox-LDL. Results In the COPD group,serum IMA concentration was significantly higher than those in the control group(0.94 ± 0.31 vs. 0.62 ± 0.25,P<0.001). The serum TOS was higher than that in the control group(6.51 ± 4.85 vs. 4.53 ± 3.81,P<0.05). The serum ox-LDL concentration in COPD group increased significantly compared with the control group(5.91 ± 3.61 vs. 4.51 ± 2.05,P<0.05). The serum HDL concentration in the COPD group was significantly lower than that in the control group(36.49 ± 9.60 vs. 44.19 ± 10.14,P<0.001). There was no sig-nificant difference in TAS,triglyceride and low LDL between the two groups. Conclusions The serum levels of TOS,ox-LDL and IMA are significantly increased in COPD patients compared with the control group,while HDL-C concentration is significantly decreased. Increase of IMA and ox-LDL in serum of patients with COPD may be relat-ed to imbalance of TOS and TAS due to chronic inflammation and oxidative stress.

Background Diabetic retinopathy (DR) is a common complication of diabetic mellitus,but its pathogenesis is still unclear.Adiponectin may restrain inflammatory reaction and reduce adhesion of vascular endothelial cell to influence diabetic microangiopathy.Relation between adiponectin and nitric oxide synthase (NOS)is less reported.Objective This study was to observe the effect of adiponectin on the expression of NOS in the retinas of diabetic rats.Methods Forty 8-10 weeks Sprague-Dawley (SD) female rats were collected.The rats were randomized into the normal control group (10 rats),adiponectin group (15 rats) and diabetic model control group (15 rats) using the random number table method.Tetraoxypyrimidine was intraperitoneally injected to establish the diabetic model in the rats of the adiponectin group and diabetic model control group,and 10 μg/kg of adiponectin was then injected into the rats of the adiponectin group.Western blot was used to detect the expression of the adiponectin protein in the rat retinas,and the expression of NOS in rat retina was located by immunochemistry.The use of the animals complied with the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results The relative amount of adiponectin (adiponectin/β-actin)in the retinas was 0.85 ± 0.21,0.79 ± 0.17 and 0.42 ± 0.08,respectively,in the normal control group,adiponectin group and diabetic model control group,with significant differences among the 3 groups (F =4.236,P =0.000).The adiponectin/β-actin ratio in the retinas of the diabetic model control group was significantly declined in comparison with the normal control group and adiponectin group (q =6.615,P =0.000 ; q =6.026,P =0.000).The NOS levels (A value) in the retinas were 0.244 ± 0.035,0.262 ± 0.032 and 0.367 ± 0.066,respectively,in the normal control group,adiponectin group and diabetic model control group,showing a significant difference among them (F =3.752,P =0.001).The A value of NOS in the diabetic model control group was significantly increased in comparison with the normal control group and adiponectin group (q =3.488,P =0.002 ; q =3.079,P =0.005).NOS expression was localized to the inner nuclear layer and retinal ganglion cell layer.Conclusions Adiponectin reduces NO content in diabetic rat retinas by regulating NOS expression.

A typical investigation on third-tier general hospitals, third-tier specialty hospitals, second-tier district or county central hospitals, urban community hospitals, and rural township health centers in Shanghai was conducted so as to examine the responsiveness of outpatients and inpatients to the health system. Most of the patients surveyed said that they could get prompt attention and that they had convenient access to medical information from the community or the mass media. More than half of the inpatients and outpatients thought that they had autonomy with regard to treatment and a greater number of patients made their own choices of doctors and nurses. Most of the patients were willing to talk freely with their doctors about their confidential medical history and could get rational explanations about their conditions from the doctors. The results indicate that reform of the health system in Shanghai has attached importance to the responsiveness of patients and that good effects have been achieved.