Objective To discuss the opportunity of transurethral resection of prostate (TURP) after transrectal prostate biopsy.Methods We analyzed 60 cases of benign prostatic hyperplasia(BPH) who underwent TURP after transrectal prostate biopsy from September 2013 to September 2015.All the patients were divided into either group A or group B in chronological order, with 30 cases in each group.There were no significant differences in age, prostate specific antigen (PSA), prostate volume, hemoglobin level, and international prostate symptom score (IPSS) between the two groups.The group A and group B were treated by TURP at 1 week and 4 weeks after transrectal prostate biopsy, respectively.The parameters including operation time, excised prostate weight, intraoperative total blood loss, bladder irrigation time, and IPSS at 3 months after operation were recorded.Results The operation time, intraoperative total blood loss, bladder irrigation time, and IPSS in the group B were significantly lower than those in the group A [(58.3±6.0) min vs.(62.0±3.3) min, t=2.952, P=0.005;(154.1±15.8) ml vs.(167.4±29.5) ml, t=2.181, P=0.035;(19.2±0.8) h vs.(20.6±2.3) h, t=3.034, P=0.004;(18.3±2.5) points vs.(20.3±2.0) points, t=3.419, P=0.001].The excised prostate weight in the group B was significantly higher than that in the group A [(37.1±4.0) g vs.(33.3±7.8) g, t=-2.341, P=0.024].Conclusions TURP performed at 4 weeks after transrectal prostate biopsy can significantly increase the excised prostate weight, reduce intraoperative total blood loss volume, shorten the operation time and postoperative bladder irrigation time, and improve urinary symptoms.In brief, we recommend that TURP be executed at 4 weeks after transrectal prostate biopsy.

OBJECTIVE To investigate the distribution and drug-resistance of Pseudomonas aeruginosa(PAE) in nosocomial infections to provide the scientific evidence for the clinical use of the antibiotics.METHODS PAE was cultured and identified according to the National Rules of Procedures Clinical Laboratory.Drug resistance was analyzed by K-B methods.RESULTS A total of 318 strains of PAE were mainly isolated from intensive care unit(ICU),departments of cerebral surgery and chest surgery.Drug-resistance of PAE to 14 kinds of antibiotics showed that SXT(91.2%),cefotaxime(89.9%),aztreonam(70.1%),gentamicin and ciprofloxacin(69.8%),respectively.And the resistance to piperacillin,levofloxacin and cefepime was 50.0%.CONCLUSIONS Drug-resistance status of P.aeruginosa is very serious.Hospital should strengthen monitoring and controlling of it.

Objective:To explore the diagnostic value of serum procalcitonin (PCT) level combined with Quantitative Computed Tomography (QCT) in elderly women with painful osteoporosis and its correlation with disease severity.Method:This study is a prospective study. From Jan. 2019 to Apr. 2020, 596 elderly women who underwent physical examination in our hospital were selected as the research subjects. All of them underwent dual-energy X-ray, PCT examination, and QCT examination serum. The diagnostic value of PCT and QCT in elderly women with painful osteoporosis was analyzed; Pearson correlation was used to analyze the correlation between the bone mineral density of lumbar vertebral 1, 2 vertebra, PCT and the severity of painful osteoporosis.Result:Among 596 elderly women, painful osteoporosis patients accounted for 50.84% (303/596) , bone mass reduction accounted for 21.98% (131/596) , and normal bone mass accounted for 27.18% (162/596) . Compared with the results of the diagnosis of painful osteoporosis by DAX, the diagnostic coincidence rates of PCT, QCT, QCT+PCT were 81.88% (488/596) , 93.62% (558/596) , and 97.31% (580/596) . QCT examination, QCT+PCT diagnosis coincidence rate is higher than PCT examination ( χ2=43.650, 83.187, P<0.05) ; QCT+PCT diagnosis coincidence rate is higher than QCT examination ( χ2=9.388, P=0.002) . The sensitivity, specificity, positive predictive value, and negative predictive value of QCT+PCT in the diagnosis of abnormal bone mass are higher than those of PCT ( P<0.05) ; the specificity and negative predictive value of QCT+PCT in diagnosing abnormal bone mass are higher than QCT Check ( P<0.05) . The bone density detected by QCT in the osteopenia group and the painful osteoporosis group was lower than that in the normal bone mass group, and the serum PCT level was higher than that in the normal bone mass group, the difference was statistically significant ( P<0.05) ; the painful osteoporosis group was in QCT detection of bone. The density was lower than that of the osteopenia group, and the serum PCT level was higher than that of the osteopenia group, the difference was statistically significant ( P<0.05) . The severity of painful osteoporosis was negatively correlated with bone mineral density detected by QCT ( r=-0.54, P<0.05) , and positively correlated with serum PCT ( r=0.59, P<0.05) . Conclusion:QCT vertebral bone mineral density determination combined with serum PCT detection has high accuracy, sensitivity, and specificity in the diagnosis of painful osteoporosis, and is closely related to the severity of painful osteoporosis, and can be used for clinical evaluation of the condition of painful osteoporosis patients.

Objective To research the clinical application effect of thrombela-stogram(TEG) for anticoagulant therapy to prevent deep venous thrombosis(DVT) in perioperative period of Orthopedics Department.Methods Sixty-eight cases of fracture patients treated with surgery in the Orthopedicsin Department of Jiangning Hospital of Nanjing were selected as the research subjects,and 42 healthy volunteers for a physical examination at the same period were selected as the control group.All fracture patients were treated with anticoagulant therapy after surgery,according to the different anticoagulants,the fracture patients were divided into the low molecular weight heparin(LWMH) group and the rivaroxaban group.On the day of the investigation,the control group was detected by TEG,and the TEG test was performed on all the patients during the perioperative period.Results There was no significant difference on the TEG test results between fracture patients and the control group(P>0.05),the TEG test results of fracture patients were normal,and the blood was not in the high coagulation state.On the 7th d of anticoagulant therapy and the end of anticoagulant therapy,the R value in the LWMH group and in the rivaroxaban group were the highest positive rate,were all more than 50%.At the end of the anticoagulant therapy,the abnormal detection rate of α angle,maximum thrombus(MA) and integrated coagulation index(CI) in the rivaroxaban group were 35.29%,32.35%,41.76%,respectively,were significantly higher than those in the LWMH group(8.82%,17.65%,11.76%),the differences were statistically significant(χ2=6.9283,5.7566,7.5556,P<0.05).After the end of the anticoagulant therapy for Doppler ultrasound,9 cases were diagnosed as DVT,and the incidence rate was 14.06%.Compared and founded,at the end of the anti coagulation therapy,the great value of the diagnostic indicators were α angle,MA and CI,the sensitivity was 64.71%,76.47%,73.53% respectively,and the specificity was 79.41%,73.53%,82.35% respectively.Conclusion After fracture surgery,the coagulation function of the patients are changed,using TEG dynamic detection can accurately understand the change of blood state in real time,and it has important reference value for the evaluation of blood coagulation function.With MA was equal to 68.35 mm as a clinical diagnosis of critical point.

Objective Under the guidance of graduate education evaluation theory,to establish the comprehensive quality evaluation standard of medical graduate students and apply it in the research of the scholarship evaluation.Methods Byusing literature study,brainstorming,expert advice and other research methods,we established comprehensive quality assessment scale.In the work of graduate scholarship,the scale was used to carry out the evaluation work,and the application of the scale,the use value and the effect of moral evaluation were studied.Results A comprehensive quality assessment scale for medical graduate students,which included 4 dimensions of moral education,training process,scientific research and social activities was established so that the students' daily performance was quantified and evaluated,which,to a certain extent,eliminated the influence of the subjective judgment to the evaluation work,and had good guidance and practicality.Conclusion Establishing comprehensive quality quantitative evaluation mechanism of the graduate students and conducting the dynamic evaluation to graduates' moral education,their academic and social activities are conducive to stimulating the development of postgraduates' comprehensive quality and improving the quality of training.

70% for 9 patients;the positive rate was between 30-70% for 4 patients;the positive rate 0.05). Conclusion Tamm-Horsfall detection of RBC in urine could be used as one of the Identification indicators for DN hematuria, and it can provide a basis for diagnosis and treatment of DN.

Objective To investigate the role of Astragahs in alleviating adhesion of neutrophils to HK-2 cells induced by postasphyxial-serum of neonate and its signal transduction mechanism. MethodsHK-2 cells were used as target cell. Control group, asphyxia group, Astragalus group were divided in the experiment. The 20％ (volume fraction) postasphyxial-serum was used as attacking factor. The following indicators were detected: cellular morphology and neutrophils adhesion were observed with inverted microscope. The activity of myeloperoxidase (MPO) in the cell suspension were determined by biochemistry assay as the indicator for adhesion of neutrophils to HK-2. Intercellular adhesion molecule-1(ICAM-1) were examined by flow eytometer. ResultsThe neutrophils numbers (MPO activity) and ICAM-1 expression in asphyxia group were higher than that of the control group, but dramatically decreased in Astragalus group (P < 0.05). ConclusionsThese data demonstrated that Astragalus could alleviate the adhesion of neutrophils from neonate with asphyxia to HK-2 and it' s intracellular signal transduction mechanism is presumably involved in the inhibition of ICAM-1 expression on HK-2 cellular membrane.

Objective To investigate the effect of electro-acupuncture pretreatment on content of interleukin (IL)-1βand IL-6 in serum and ischemic penumbra, and apoptosis in ischemic penumbra in rats after cerebral ischemia-reperfusion injury. Methods Thirty-six male Sprague-Dawley rats were randomly divided into sham group (n=12), model group (n=12), and electro-acupuncture pretreatment group (n=12). The middle cerebral arteries were occluded for 120 minutes and reperfused. Twenty-four hours after reperfusion, the level of IL-1βand IL-6 in serum and brain tissue was detected with enzyme-linked immunosorbent, and apoptosis of ischemic penumbra was detected with TU-NEL. Results The content of IL-1βand IL-6 in the serum and brain tissue, and the number of TUNEL-positive cells decreased in the elec-tro-acupuncture pretreatment group compared with that in the model group (P<0.01). Conclusion Electro-acupuncture pretreatment may in-hibit inflammatory response and apoptosis in cerebral ischemia-reperfusion injury.

ObjectiveTo investigate the clinical efficacy of acupuncture plus keritherapy for knee osteoarthritis.MethodForty patients with knee osteoarthritis meeting the inclusion criteria were allocated, using a random number table, to treatment and control groups, 20 cases each. The treatment group received acupuncture plus keritherapy and the control group, acupuncture. Treatment was given for four weeks. The clinical therapeutic effects were evaluated using the Visual Analogous Scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in the two groups.ResultAfter four weeks of treatment,the VAS score and the WOMAC score decreased significantly in the treatment group of patients compared with the control group; there was a statistically significantdifference (P<0.05).ConclusionAcupuncture plus keritherapy can relieve pain around the knee and improve knee dysfunction in patients with knee osteoarthritis.

Objective To explore the effect of exercise preconditioning on apoptosis and expression of P53 protein in ischemic penum-bra in rats after cerebral ischemia-reperfusion. Methods Thirty-six Sprague-Dawley rats were randomly divided into sham group, model group and exercise preconditioning group, with twelve rats in each group. The middle cerebral artery occlusion (MCAO) model was estab-lished with modified Longa's method. TUNEL method was used to observe the apoptosis of neural cells in the ischemic penumbra. Western blotting was used to detect the expression of P53 protein in the ischemic penumbra. Results Twenty-four hours after cerebral ischemia-reper-fusion, the number of TUNEL positive cells was more in the model group than in the sham group (P<0.01), and was less in the exercise pre-conditioning group than in the model group (P<0.01). The expression of P53 protein was higher in the model group than in the sham group (P<0.01), and was lower in the exercise preconditioning group than in the model group (P<0.01). Conclusion Exercise preconditioning coud down-regulate the expression of P53 protein in the ischemic penumbra, and inhibit the apoptosis of cortical cells.