Objective To evaluate the efficacy and safety of α1-adrenergic blockers for treating young men with primary bladder neck obstruction (PBNO). Methods A retrospective review was done of the presenting symptoms and videourodynamic findings of 22 young men younger than 35 years with PBNO. Mean age was 28 years (range 18 to 35). The presenting symptoms were hesitancy in 21 (95%), weak stream in 17(77%), frequency in 16(73%), urgency in 8(36%) and pelvic pain in 6 (27%). Mean symptom duration was 28(3-62)months. A dose of 4 mg Doxazosion was adminis-tered for at least 6 months. International prostate symptom score(IPSS), Quality of life(QOL), uro-flowmetry, post-void residual urine and blood pressure were assessed before and 6 months after medi-cation. Improved urine flow was defined as at least 3 ml. per second increase in the maximum flow rate. Improved symptom was defined as more than a 40% decrease in IPSS. Successful treatment was defined as improved in urine flow and symptoms. Results Follow-up data were available for 21 of 22 patients. The medication period was 8.7±2.5 months and follow-up duration was 12.3±4.9 months. Mean Ⅰ-PSS decreased from 16.9±3.7 to 10.7±4.5. Mean QOL decreased from 4.3±1.2 to 2.5±1.0. Mean maximum flow rate increased from (9.8±3.5)ml to (14.9±3.6)ml. per second. Mean post-void residual urine decreased from (78.2±35.6)ml to (46.5±19.4)ml. There were significant differences(P<0.01). Treatment was successful in 14 patients (67%). Drug tolerability was good. Mean blood pressure was (110.0±7.9)/ (75.0±5.9)mm Hg and (107.0±8.7)/(72.0±7.1)mm Hg before medicine therapy and after 6 months medication(P>0.05). Conclusions Videourody-namics is the diagnostic gold standard of PBNO. In our experience α1-adrenergic blockers are clinically effective therapy and safety for PBNO and have been well tolerated in young male patients.

Objective To explore the application and clinical outcome of intracapsular reduction for comminuted distal radial fractures.Methods From January 2003 to October 2005,37 cases of comminuted fractures of distal radius were treated in our hospital.They were categorized according to the AO classification,and underwent open intracapsular reduction,internal fixation with either locking com- pressing plate(LCP)or external fixator according to the types of fractures.The results of treatment were evaluated by functions and X-ray examination of involved wrists.Results All the 37 patients were fol- lowed up regularly.Satisfied synostosis by X-ray had been acquired.The wrist functions were evaluated by the Gartland and Werley system to find excellent result in 26 cases,good in eight,fair in two,and poor in one,with the excellent and good rate of 92%.Conclusion For the treatment of comminuted distal radial fractures,open intracapsular reduction can obtain fast fracture healing and recovery of wrist joint function.

Objective To investigate the causes and treatment of familial neurohypophyseal diabetes insipidus with hydronephrosis.Methods A retrospective analysis was conducted in 6 cases (5 males and 1 female,aged 11 to 53 years) of familial neurohypophyseal diabetes insipidus with hydronephrosis treated in our institute from June 2009 to December 2010.All cases had polydipsia and polyuria since their childhood.The daily output of urine ranged from 5,290 to 15,040 ml.The urine specific gravity was less than 1.005.The water deprivation and vasopressin injection test showed positive results,and MRI showed that the shape and size of pituitary gland were in normal range.Ultrasound and IVU showed that all cases had hydronephrosis.Five adult cases were administered with Desmopressin 0.2 mg three times a day,and 1 juvenile patient given half dosage of Desmopressin as in adult.The case No.1 underwent percutaneous nephrostomy and bilateral ureteral reimplantation.Case No.2 received urethral catheterization for 5 days and Tamsulosin.Three cases with urinary tract infection were given antibiotics on the base of urine culture and antibiotic sensitivity test results.Follow-up was undertaken every 3 mon for the duration of 18-36 mon.Results In 6 cases,polydipsia and polyuria were significantly improved after the treatment.Daily urine output dropped to 6000 ml in 5 adult cases and decreased to 2000 ml in the juvenile case.The flank sore of case No.1 was relieved after percutaneous nephrostomy,and hydronephrosis improved 6 mon after bilateral ureteral reimplantation.The residual urine volume of case No.2 was reduced to 40 ml,and no recurrence was observed after anti-infection therapy.During the follow-up,6 cases showed relieved hydronephrosis and no recurrent infection.Conclusions It is of important to reduce the urine volume for the treatment of familial neurohypophyseal diabetes insipidus with hydronephrosis.Early diagnosis and treatment of the diseases is crucial for the improvement of renal function.

OBJECTIVE To discuss the characteristics and risk factors of nosocomial infection inpatients with chronic kidney disease.METHODS The data from chronic kidney disease(CKD) patients retrospectively analyzed.RESULTS The nosocomial infection rate of CKD patients was 14.73%,urinary tract was the most comun site,The main-pathogens were Gram-negative bacteria,and then Gram-positive bacteria and fungii.The patients with diabetic nephropathy,lupus nephritis,aging,lower glomerular filtration rate,hypoproteinemia,anemia,and long time duration were easy to get nosocomial infection.CONCLUSIONS Nosocomial infection in CKD patients is related to underlying diseases,age,kidney function,serum albumin level,hemoglobin level,duration time in the hospital.

OBJECTIVE To discuss the clinical traits,pathogenesis and TCM stepwise treatments of fungal urinary tract infection.METHODS According to the risk factors and clinical character of fungal urinary tract infection,we clarified the mechanism of the disease.The principal aspect was spleen-kidney vacuity detriment and the secondary incidental was accumulated damp-heat and static blood in the lower burner,viz weaken healthy qi and excessive pathogenic factor.Hence during the clinical treatment we should regulate faculty condition.In the acute infection period we should give priority to dispel evils supplemented by the recovery of right qi.In the convalescence we should pay more attention to support right supplemented by dispelling.RESULTS The most common pathogen of fungal urinary tract infection was Candida albicans.The TCM stepwise treatments of fungal urinary tract infection together with regulatiy entire faculty condition had the characteristics of high efficacy and few side effects.CONCLUSIONS The TCM stepwise treatments of fungal urinary tract infection has more potentiality which deserves further study.

BACKGROUND: Optical coherence tomography(OCT) is a new type of noncontactable, noninjurious retinal tomographic technique. Minor serous detachment in retinal neuroepithelial layer can be resoluted and shown by it. The range of inferior fluid of retinal neuroepithelail layer or pigment epithelial layer can also be quantitatively measured to evaluate the recovery of vision.OBJECTIVE: To study the applicative value of OPT in evaluating the relation of vision and neuroepithelial layer in idiopathic central serous chorioretinopathy(ICSC) and its prognosis.DESIGN: Single sample study.SETTING: Ophthalmologic center in a university hospital.PARTICIPANTS: Patients with ICSC who were primarily diagnosed from January 1999 to June 2003 in the Ophthalmologic Center of the Medical College of Jinan University were included. There were 32 males and 8 females, with an average of(36.2 ± 5.6) years old.INTERVENTIONS: Zeiss-Humphrey OCT imaging meter was used for the examination. The maximal range and height of detachment in the serous detachment region of ICSC were measured respectively, and average value and standard deviation were then calculated.MAIN OUTCOME MEASURES: Vision and the maximal range and height of serous detachment.RESULTS: Local detachment of retinal neuroepithelial layer in the center of macula retina was shown in the OCT images of the 40 eases(41 eyes) with ICSC. Detachment ranged from 705 to 5 720 μm[an average of (3 051 ± 1 338) μm], with the height from 55 to 491 μm[an average of (270 ± 114) μm] . Four eyes were complicated with serous detachment of pigment epithelial layer. And it was suggested by statistical analysis that the range and height of detachment were related with vision.CONCLUSION: OCT, as an objective noninjurious retinal tomography, its high resolution has important value and special predominee in the diagnosis, quantitative analysis and the detection and follow-up of optical functional assessment during the course of the ICSC.

OBJECTIVE:To establish the quality standard of Chushi pill. METHODS:Microscopic identification and TLC were adopted for the qualitative identification of Cortex moutan,C. dictamni,Angelica sinensis,Rubia cordifolia and Gardeniae fructus in Chushi pill;HPLC was performed to determine the contents of paeonol and baicalin. It was performed on column of Kro-masil 100-5 C18 with mobile phase of methanol-water-phosphoric acid(47∶53∶0.2,V/V/V)at the flow rate of 1.0 ml/min,the detec-tion wavelength was 280 nm,the temperature was 25 ℃ and the volume was 10 μl. RESULTS:The microscopic identification showed microscopic characteristics of C. moutan and C. dictamni,and characteristics of A. sinensis,R. cordifolia and G. fructus were identified by TLC;the linear range of paeonol was 0.106 24-2.124 8 μg(r=0.999 9)and baicalin was 0.059 04-1.180 8 μg (r=0.999 9);RSDs of precision,stability and reproducibility tests were no more than 2.06%;average recoveries were respective-ly 101.56%(RSD=1.68%,n=9)and 100.16%(RSD=1.13%,n=9). CONCLUSIONS:The method is simple,accurate and re-producible,and can be used for the quantity control of Chushi pill.

Objective To explore the methods for coverage of the defect of great toe after the wrap-a- round flap transferand decrease the morbidity of donor site in great toes.Methods Twenty-five patients received three kinds of procedure for immediate resurfacing of donor defect of the great toes during wrap-around flap transferAmong them9 cases received the free flaps for coverage of defect in donor great toes12 cases was repaired by local pedieled dorsal or plamarpedis flapsand the other cases were treated by the nail-flap of second toe.Results All the flaps were survivalTwo patients received the flap thinning procedure in 6 months laterall patients were satisfied with cosmetic and functional outcomeThe appearance and sensory function of donor toe repaired by second toe nail-flap was best among three methods.Conclusion Accord- ing the detect situation of great toesthree kinds of flap were selected for immediate coverage of donor site, which can decrease the complication of donor great toe at the most.

Adult ; Female ; Humans ; Kidney Glomerulus ; metabolism ; pathology ; Lipoproteins ; metabolism ; Male ; Nephrosis, Lipoid ; metabolism ; pathology

OBJECTIVETo evaluate the short term effectiveness of lumbar disc herniation by Coflex.

METHODSFrom December 2007 to June 2008, 31 patients (16 males and 15 females) were treated by Coflex. The average age was 51.4 years (range, 33 - 70 years). The average period of follow-up was 10 months. To evaluate the short term effectiveness of lumbar disc herniation by Coflex by JOA, VAS, the conventional radiography and oswestry disability index (ODI).

RESULTSThe average JOA score increased from 9.1 +/- 1.1 preoperatively to 26.4 +/- 1.7 at 6 month postoperatively. ODI decreased from 24.7 +/- 4.8 preoperatively to averaged 4.5 +/- 1.1 at 6 months postoperatively. The VAS score decreased from 7.9 +/- 0.8 to 3.0 +/- 0.9. The clinical symptoms after operation were improved significantly. There were statistically significant differences between the preoperative and postoperative HD (height of dorso- intervertebral discs), DS(distance across the two adjacent spinous processes), DI (distance of intervertebral foramina). The average HD increased from (7.9 +/- 1.1) mm preoperatively to (10.8 +/- 1.3) mm after operation. The average DS increased from (28.3 +/- 2.4) mm preoperatively to (36.4 +/- 1.7) mm postoperatively. The average DI changed from (18.8 +/- 1.0) mm preoperatively to (21.6 +/- 1.7) mm postoperatively. Complications occurred in 3 patients (9.6%). One case complained of persistent low back pain. One case showed opposite lower limb pain in 3 weeks after operation, and was cured after appropriate treatment. One case had the loosening of Coflex in 6 months after surgery, but did not appear related clinical symptoms.

CONCLUSIONCoflex for lumbar disc herniation can increase the HD and DI significantly, and it has positive meaning for keeping height of lumbar vertebral space and treating the nerve root symptom of lumbar disc herniation.

Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Internal Fixators ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome