ObjectiveTo evaluate the effect of double dosage tolterodine (4 mg/d) on patients with detrusor overactivity after spinal cord injury (SCI).Methods30 patients with detrusor overactivity after SCI who poorly responsed to tolterodine (2 mg/d) were treated with double dosage tolterodine. Urine leakage and quality of life by ICI-Q-SF was used to assess the treatment effect.Results28 of 30 patients completed this study after 4 weeks. 2 patients quited for dry mouth. After treatment with double dosage tolterodine, bladder capacity increased significantly from (196.3±44.7) ml to (393.5±54.3) ml, urine leakage decreased from (4.96±2.15) to (3.92±2.14) times per day. 25 of the 28 patients showed improvement in quality of life by ICI-Q-SF. ConclusionTreatment with double dosage tolterodine showed improvements in bladder capacity and urine leakage in patients with detrusor overactivity after SCI if the patients could tolerate the dry mouth and other side effects.

Micturition is a complicated physiological activity and is controlled by many central pathways. With the application of positron emission tomography (PET), single photon emission computed tomography (SPECT) and functional magnetic resonance imaging (fMRI), people can observe the activity of the brain during the course of micturition and urinary continence. This paper will review the physiological micturition and central pathways controlling for micturition.

Voiding dysfunction is a common lower urinary tract disorder, including urgency incontinence, urgency frequency, urinary retention and so on. Sacral neuromodilation is adapt for the patients who are fail for the conservative treatments and are intend to have operation. This paper would review some of this new method, such as the history, mechanism, indication, technical procedure and curative effect.

The reproductive toxicity of environmental estrogens(EEs)has become an extensively studied subject in environmental science and reproductive medicine nowadays.Many epidemiology data and experimental evidences indicated that EEs may significantly cause the disorders of male sex differentiation such as microphallus,hypospadia,cryptorchidism and masculinization behavior disorder and so on.The mechanism includes estrogenic activity,anti-androgenic activity as well as other feedback regulation and signal transmission which influence hormones metabolism.

AIM: To investigate the effect of homocysteine(Hcy) on the apoptosis of endothelial cells (EC). METHODS: First-passaged human umbilical vein endothelial cells (hUVEC) were cultured with M199 containing 3 mmol/L Hcy. hUVEC apoptosis was detected as follow: demonstration of nuclear changes by Hoechst 33258 staining, agarose gel electrophoresis of DNA fragments, detection of apoptotic cells by flow cytometry following Annexin V-PI doubled stain, Western blot for P53 and Bax protein detection and colorimetry detecting caspase-3 activity. RESULTS: Compared with control, homocysteine induced characteristic apoptotic changes in hUVEC. The chromosomal DNA of hUVEC appeared “DNA ladder” by agarose gel electrophoresis. Apoptotic cells were increased significantly (P

In order to improve the efficacy of vibration expectoration and prevent secondary injury in patients with chest trauma,the body surface marking method was used in vibration expectoration.The exact injured locations and areas were identified via CT ot X-ray results.Then,the restricted and focused areas of expectoration were marked with red and green colors,which could guide the machines to avoid the fracture sites,reduce pain,prevent secondary injury and administrate effective expectoration in the areas of sputum and atelectasis.However,the dynamic CT or X-ray results must be used for reference to ensure the accuracy of the body surface marking.

Objective To study the diagnosis and treatment of pancreatic sinistral portal hypertension with splenomegaly.Method From January 2010 to December 2012,twenty-six cases of pancreatic sinistral portal hypertension with splenomegaly were retrospectively analyzed.Results The underlying pancreatic diseases were chronic pancreatitis (n=12,46 ％),pancreatic pseudocyst (n=5,19％),mass of pancreatic body and tail (n=6,23％),autoimmunie pancreatitis (n=2,8％) and pancreatic trauma (n=1,4 ％).All the 26 patients presented with splenomegaly,but there was no evidence of cirrhosis or abnormal hepatic function.Three cases presented with a history of upper gastrointestinal bleeding.Gastroscopy or upper gastrointestinal visualization revealed all 26 patients had varices in the gastric fundus and 6 patients had inferior segment oesophageal varices simultaneously.19 patients underwent operative treatment,2 patients underwent splenic artery embolization and 5 patients were treated conservatively.22 patients were followed up for 6 months to 30 months,the follow-up rate was 85 ％,and there were no upper gastrointestinal bleeding.Hypersplenism disappeared in all the 19 patients after operation.2 patients succumbed to pancreatic malignant tumor.Conclusions Splenomegaly is one characteristic clinical manifestation of pancreatic sinistral portal hypertension.It could be cured by operation.The choice of treatment depends on the patient's condition.The management of the primary pancreatic disease should also be emphasized.

Objective To investigate the clinical efficacy of ilaprazole and bismuth combined ten-day standard quadruple therapy and sequential therapy in the treatment of patients with Helicobacter pylori (H .pylori)infected chronic gastritis.Methods A total of 200 patients with H .pylori-positive chronic gastritis diagnosed by gastroendoscopy examination and rapid urease test (RUT)were randomly divided into standard quadruple therapy group and sequential therapy group,100 cases in each group.One group received ilaprazole,bismuth,amoxicillin-clavulanatepotassium and ofloxacin 10-day standard quadruple therapy, and the other group received ilaprazole, amoxicillin-clavulanatepotassium, ofloxacin and furazolidone 10-day sequential therapy.In four to six weeks after the therapy,the condition of H .pylori eradication was detected by a 14 C-urea breath test.The improvement of clinical symptoms and adverse effects were also observed. Normal distributed and variance homogenized measurement data were compared by t test,while unordered categorical data were analyzed by chi-square test and the exact probability method,and categorical data were compared by two independent sample rank sum test.Results The per-protocol analysis values of H .pylori eradication rates of the standard quadruple therapy group and the sequential therapy group were 88.54%(85/96)and 87.23%(82/94),respectively,while the intention-to-treat analysis values were 85 .00%(85/100)and 82.00%(82/100 ),respectively.The effective rates of symptomatic relief of upper abdominal pain,acid regurgitation,heart burning in the standard quadruple therapy group and the sequential therapy group were 95 .83%(92/96)and 95 .74%(90/94),respectively. The incidence of adverse effects which weve very mild was 6.25 % (6/96 ) and 7.44% (7/94 ), respectively.There was no statistically significant difference in the above three factors between the two groups (all P >0.05).Conclusions Ilaprazole and bismuth combined 10-day standard quadruple therapy and sequential therapy in the treatment of patients with H .pylori positive chronic gastritis both achieves high rates of H .pylori eradication and symptom relief with mild adverse effects.

Objective To evaluate the clinical characteristics,diagnosis and treatment method of pancreatic sinistral portal hypertension caused by tumors in the body and tail of the pancreas.Methods A retrospective review of 40 patients diagnosed with pancreatic sinistral portal hypertension at Peking Union Medical College Hospital from January 2007 to December 2012 was performed.Results The Initial symptoms were epigastric pain and discomfort (n =12),emaciation (n =5),low-back pain (n =4),splenomegaly (n =2),hematemesis and melena (n =4),hypoglycemic coma (n =1).All 40 patients had splenomegaly and varices in the gastric fundus with normal liver function.8 had combined esophageal varices.24 had hypersplenism and 26 had elevated serum CA19-9 level.25 patients received surgical intervention and 15 were treated conservatively.Pathology confirmed malignancy in 29 patients and benign lesions in 11.Thirty-five patients (35/40,88％) were followed up for 12 to 72 months.For patients undergoing surgery,hypersplenism and varices in the gastric fundus were all relieved.There was no upper gastrointestinal bleeding occurred during follow-up.For patients treated conservatively,hypersplenism remained stable and among them 4 patients had upper gastrointestinal bleeding,and successfully treated by medication,therapeutic endoscopy and interventional therapy.Conclusions Patients with pancreatic sinistral portal hypertension caused by tumor in the body and tail of the pancreas can be cured successfully by surgery.In those patients portal hypertension can present as initial clinical manifestation.

Objective To describe body mass index (BMI) changes in migrant children with overweight and obesity in Beijing treated by the exercise and dietary intervention programme.Methods BMI was assessed at before and after the intervention in 30 migrant obesity and overweight children aged 9 ～ 12 in two schools from March,2010.Results BMI reduced significantly one week after the intervention ( P ＜ 0.05 ),but from two months to six months after the intervention BMI increased again to the pretreatment level( P ＜ 0.05 ).Conclusion The intervention was successful in decreasing BMI,however maintenance of BMI after treatment was not easy.The controlling of obesity and overweight is a long term process which needs the cooperation and supervision of their parents.