Objective To investigate the efficacy of clinical case-based PBL in clinical practice in department of urology.Methods Medical students admitted by our clinical medical school in 2006 and 2007 were involved.Fifty-six students of 2007 grade were chosen as study group while 49students of 2006 grade as control group.Students in study group were taught by clinical case-based PBL method while those in control group by traditional method.All results were analyzed by SPSS 11.0.Results The scores in study group were higher than those in control group with statistical differences (82.84 ± 12.35 vs.72.95 ± 11.13 ; t =4.29,P ＜ 0.01).Students in study group showed more interests in practice lessons.Teachers were more satisfied with the overall performance of students in study group.Conclusions Clinical case-based PBL can increase students' overall performance such as better coordination,better clinical skills and better open-minded clinical case solution.

Objective　To study the malignant or benign characters of lung mini nodules for diagnosis and treatment.Methods　A retrospective analysis was performed on 80 post-operative cases with pathologically confirmed malignant or benign lung mini-nodules.Results　Lung mini-nodule resection cases accounted for 17.7%(80) out of a 451-cases group.Malignant cases accounted for 73.7%(59/80)，benign cases 26.3%(21/80).Most of the malignant cases were squamous cell carcinoma and adenocarcinoma,while most of the benign cases were tuberculosis and inflammatory pseudo-neoplasms.As for pTNM staging in malignant cases,there were 28 in pT1N0M0，19 in pT1N1M0,1 in pT1N1M1,10in pT1N2M0 and 1 in pT1N2M1;the average survival time was 29.4 months.The accurate rate of pre-operative X-ray and CT scan was 45% and 76.2% respectively.Conclusion　For patients with lung mini-nodules ＜2 cm CT value at 37HU,and the nature unknown ,resection is suggested.

Objective To study whether CK20 expression could be served as a noninvasive test for detecting and monitoring bladder cancer. Methods Reverse transcriptase polymerase chain reaction (RT PCR) was used to determine the expression of CK20 in cells collected from the urine of 10 healthy volunteers,41 patients with bladder cancer and in 20 hematuria patients with bladder cancer excluded. Results CK20 amplification band (370bp) was obtained with mRNA extracted from TCC cells of bladder cancer. Of 41 patients with bladder cancer, 37 specimen were positive.No false positive cases were found in the 10 healthy controls and only in 3 of the 20 hematuric cases.Of the 3 false positive, 2 had pelvic cancer and 1 chronic inflammation. CK20 was positive in 23 of the 25 G 1 patients,in 8 of the 9 G 2 patients,and in 6 of the 7 G 3 patients. Conclusions The preliminary results showed that CK20 might be a potential biomarker for the noninvasive detection of bladder cancer by means of assaying urothelial cells from the voided urine specimen with RT PCR.

Objective To evaluate the effect of ImmunoCyt on the early diagnosis of bladder cancer by comparing the result of cystoscopy with that of cytology. Methods Eighty-six consecutive patients with bladder cancer (mean age,63 years) were included in this group.Among them 38 had undergone transurethral resection of superficial transitional cell carcinoma and had been followed up and 48 had hematuria.These patients were evaluated with standard cytology and ImmunoCyt test.Then all the patients underwent cystoscopy and suspected lesions were biopsied. Results Transitional cell carcinoma of bladder was confirmed pathologically in 28 cases.The sensitivity of ImmunoCyt (82%) was superior to that of cytology (39%, P

Objective To investigate treatment effect of the type of foot drop in patients with lumbar disc herniation.Methods Clinical data of 34 patients with foot drop in lumbar disc herniation who were treated in Spinal Surgery Department of Shunyi District Hospital of Beijing from January 2006 to December 2013 were retrospective analyzed,all patients were treated by operation.After 24 months of follow-up,the effect was observed,the prognosis and related factors were analyzed.Results Two years after operation,the recovery of the patients was excellent in 4 cases and good in 19 cases,common and poor in 11 cases,and the excellent and good rate was up to 67.6%(23/34).Analysis results showed that after 3 to 24 months after surgery,the anterior tibial muscle strength grades(grade 0-5) corresponding score were 28 points preoperatively,59 points at 3 months after surgery,69 points at 6 months after surgery,92 points 1 year after surgery,reached 95 points 2 years after surgery.Muscle strength score of patients with an increasing trend,especially after 3 months to 12 months after the operation.Conclusion The drop occurred should be operated as soon as possible,recommendations for open surgery,complete decompression,avoid injury.Three months to 1 years after operation is the key period of recovery.

Objective To investigate the short segment(less than 2 segments)of lumbar posterior open surgery in the application of iodophor rinse operation field for the prevention of wound infection effect.Methods One hundred and sixty-four cases patients who underwent all lumbar posterior short segment(less than 2 segments)decompression and fusion in Shunyi District Hospital of Beijing from January 2012 to December 2015 were selected as study objects,and were randomly divided into two groups according to random number table method,including 87 cases of single application of physiological saline(saline group)and 77 cases with diluted iodophor rinse liquid during the operation(diluted iodophor group).The incidence of infection in patients with different irrigation patterns during 3 months after the operation was followed up,and the results were analyzed by Fisher exact probability method.Results The infection rate of saline group was 8.05％(7/87),1.30％(1/77)of iodophor group,there was significant difference between two groups(P=0.04).Conclusion The application of iodophor rinse operation field for the prevention of wound infection has obvious effect on lumbar posterior open surgery.

OBJECTIVE: To explore the mechanism, clinical characterization, diagnosis and therapeutic approach of vocal process granuloma(VPG) induced by gastroesophageal reflux. METHOD: We performed a retrospective review of 4 cases. RESULT: In 4 male cases, 3 cases had no obvious symptoms of stomach and esophagus and 1 case had symptoms of bloating and acid reflux. Additionally, 4 cases in which lesions were all located to the left side were diagnosed by trial therapy with proton pump inhibitors (PPIs) with good responding. 2 of 4 cases were relapsed after operations. Meanwhile 4 patients were treated by Rabeprazole for acid suppression therapy and 3 cases were cured and 1 invalid case was cured by Pantoprazole. All patients were followed up for 4-48 months with no recurrence. CONCLUSION Gastroesophageal reflux is an important pathogenic factor to the VPG. The majority of patients with VPG do not have gastroesophageal reflux symptoms. Besides, most lesions located in the left are associated with sleeping position. The diagnosis is mainly based on the laryngoscope examination and trial of acid suppression therapy. Moreover, recurrence risk is high-with simple operation in VPG therefore the main treatment is a antireflux and it is also valid by replacing byother PPI treatment. The treatment must be long enough. Meanwhile, the comprehensive treatment should be noticed.
2-Pyridinylmethylsulfinylbenzimidazoles ; therapeutic use ; Arytenoid Cartilage ; pathology ; Gastroesophageal Reflux ; complications ; drug therapy ; Granuloma ; etiology ; Humans ; Male ; Pantoprazole ; Proton Pump Inhibitors ; therapeutic use ; Retrospective Studies ; Treatment Outcome

Objective To evaluate the clinical effect of emergency pelvic external fixation in hemodynamically unstable patients with pelvic fracture.Methods The clinical data of 56 hemodynamically unstable patients with pelvic fracture from January 2008 to December 2013 were selected.The changes of hemoglobin,mean arterial pressure,heart rate,serum lactate,urine volume,norepinephrine dosage before and after surgery for 24 h were compared and analyzed.Results Compared with those before surgery,the levels of hemoglobin,mean arterial pressure,serum lactate,urine volume,heart rate after surgery for 24 h were significantly improved:(109 ± 12) g/L vs.(69 ±22) g/L,(87.8 ±6.5) mmHg (1 mmHg =0.133 kPa) vs.(55.8 ± 7.7) mmHg,(6.3 ± 5.1) mmol/L vs.(10.8 ± 6.6) mmol/L,(35.9 ± 9.9) ml/h vs.(17.6 ± 8.4) ml/h,(84.2 ± 15.4) times/min vs.(146.4 ± 12.1) times/min,and the norepinephrine dosage was significantly reduced:(0.8 ± 0.2) μ g/ (kg· min) vs.(2.2 ± 0.8) μ g/ (kg· min).The differences had statistical significance (P ＜ 0.05 or ＜ 0.01).Conclusion Bedside pelvic external fixation can rapidly improve shock symptom in hemodynamically unstable patients with pelvic fracture,which is safe and efficient.

This study was aimed to observe the influence ofQing-Chang Hua-Shi Recipe (QHR) on IL-6trans-signaling in experimental colitis mice, in order to initially explore the possible mechanisms of QHR for ulcerative colitis (UC). TNBS/ethanol was used in the establishment of colitis mice model. After intervention of medication, ELISA was used in the detection of soluble Interleukin-6 receptor (sIL-6R). Real-time PCR was used to detect the mRNA expression level of IL-6 and glycoprotein 130 (gp130). Western blot was used in the observation of protein expression of IL-6 and gp130 in the colonic mucosa. The results showed that the level of sIL-6R, the mRNA and protein expression of IL-6 and gp130 in the model group were significantly higher than that in the control group. QHR was able to reduce the sIL-6R level (P < 0.01), decreased the mRNA and protein expression of IL-6 and gp130 (P < 0.01) in the colon tissues among experimental colitis mice. It was concluded that QHR had good anti-inflammatory effects on experimental colitis mice. It might be associated with influencing IL-6trans-signaling.

Objective To investigate the treatment of Pipkin fractures and curative effect. Methods From January 2003 to November 2009, we treated 19 cases of posterior dislocation of the hip with fracture of the femoral head,with type Ⅰ 8 cases, type Ⅱ6 cases, type Ⅲ 1 case, type Ⅳ4 cases. Seventeen patients were treated according to the illness with internal fixation treatment. Results Among type Ⅰ 8 cases, 2 cases were good with conservative treatment, 3 were excellent and 3 were good with surgical treatment;Among type Ⅱ6 cases, 3 were excellent, 2 were good, 1 was fair; 1 patient of type Ⅲ was fair; In 4 cases of type Ⅳ, 1 case was excellent, 2 cases were good, 1 case was fair. Conclusions Surgical treatment as soon as quickly is preferred for posterior dislocation of the hip with fracture of the femoral head( Pipkin fractures) , but the surgical time and methods should be chosen according to patients' detailed illness. It is important reserving the hip bone for preventing traumatic arthritis, and surgical skills to protect blood supply should not be ignored.