OBJECTIVE:To discuss the prevention and cure of anaphylactic shock caused by trasylol.METHODS:The anaphylactic shock was statistically analyzed among3862cases that were given slight dosage of trasylol before operation by intravenous drip.Among which,82cases had anaphylactic shocks,which accounted for2.12%of the total.RESULTS&CONCLUSION:The incidence rate of anaphylactic shock from trasylol by intravenous drip is quite high,thereby preparation of prevention and emergency treatment should be ready.

Objective To investigate the long-term effects of intrauterine mild hyperglycemia exposure and postnatal high fat diet on the body weight and metabolism of offspring through a pregnant rat model of intrauterine mild hyperglycemia.Methods Twenty-one pregnant Wistar rats were randomly divided into intrauterine hyperglycemia group and control group.Twenty percent streptozotocin (STZ,25 mg/kg)was given to rats of intrauterine hyperglycemia group by a single intraperitoneal injection to induce intrauterine mild hyperglycemia; control group rats received an equal volume of citric acid-sodium citrate buffer.Off springs were divided into 4 groups:exposed to intrauterine hyperglycemia and fed with normal diet group(group DN)or high fat diet group (group DF) ; exposed to intrauterine euglycemia and fed with normal diet group(group CN)or high fat diet group(group CF).The blood glucose levels of pregnant rats in two groups and body weights of offsprings in four groups were recorded.At the age of 28 weeks,the mesenteric fat amount,epididymal amount,perirenal fat amount,total triglyceride (TG)and high density 1 ipoprotein-cholestrol(HDL-C) were measured in all four groups.Results (1) The average blood glucose level of intrauterine hyperglycemia group[(16.6 ± 3.4) mmol/L] was significantly higher than that of the control group [(5.8 ± 1.1) mmol/L,P ＜ 0.01].(2) On the birth day,3 weeks and 4 weeks,the body weight of group DN [(7.4 ± 0.6),(44.1 ± 5.9),(79.6 ± 7.4) g] and group DF [(7.4 ± 0.2),(43.9 ±6.9),(76.1 ± 5.8) g] were remarkably increased compared with group CN [(6.6 ± 0.5),(35.6 ± 4.4),(71.5±6.8) g,P＜0.05]; but the body weight in group CF [(6.7 ±0.5),(33.0 ±6.5),(66.1 ±10.2) g] had no statistical difference compared with group CN(P ＞ 0.05).(3)From then on,the bodyweights of the offsprings in four groups presented an increasing trend,but there was no statistical difference until 28 weeks(P ＞0.05).(4) The perirenal fat amount of group DN,group CF and group DF [(13.8 ±3.3),(14.3 ± 3.2),(18.4 ± 1.3) g] were remarkably increased compared with group CN [(9.7 ± 3.5) g,P ＜ 0.05] ; the epididymal fat amount of group CF and group DF were also significantly increased compared to group CN(P ＜ 0.05) ; the mesenteric fat amount in four groups had no statistical difference (P ＞ 0.05).(5) The TG level of group DN,group CF and group DF[(0.52 ±0.14),(0.52 ±0.09),(0.54 ±0.17)mmol/L] were significantly higher compared to group CN [(0.41 ± 0.09) mmol/L,P ＜ 0.05],but there was no statistical difference within the first three groups (P ＞ 0.05) ; the HDL-C level in four groups had no statistical difference(P ＞ 0.05).Conclusions In intrauterine mild hyperglycemia environment,there were some evidently metabolic changes observed in the offspring,including body weight increasing on birth day and early postnatal period,visceral fat amount increasing and lipid metabolism disorders,which could be aggravated by postnatal high fat diet.

Objective To establish and assess the high-birth-weight offspring model of the diabetic rat induced by stueptozotocin,and the long-term metabolic impact of maternal hyperglycemia of those offsprings.Methods Streptozotocin (STZ,25 mg/kg) was given to Wistar rats (G group,n =14) once intraperitoneally to induce maternal hyperglycemia model (blood glucose between 10-20 mmol/L),and there still had a number of rats defined as severe hyperglycemia model group (SG group,n =5).The Control group (C group,n =7) were given the same volume citrate buffer solution.The body weight and blood glucose were recorded,and the lavaging glucose tolerance test (LGTT) was performed by a glucose meter in the gestation.The offsprings were corresponding allocated into 2 groups,and the birth weight were recorded.All the offsprings were observated body weight,blood glucose blood pressure (male rats only),and so on.Results (1) The blood glucose of G group (16.8 ±5.4 mmol/L) and SG group (20.5 ±5.6 mmol/L) were increased significantly as compared with C group (7.0 ± 1.4 mmol/L) 5 days after the model was established (P ＜ 0.01) ; and the average blood glucose of G group (16.6 ± 3.4 mmol/L) and SG group (23.8 ± 1.5 mmol/L) increased too as comparede with C group (5.8 ± 1.1 mmol/L),the difference was significance according to statistics (P ＜ 0.01).(2) According to the LGTT result,which operationed on generation day 4 and day 10,the blood glucose of every time point of G group were increased significantly as compared with C group (P ＜ 0.01).(3) The male and female birth weight of G group was remarkably higher than the C group and the SG group (P ＜ 0.05),and the blood glucose of SG /G/C group was (6.5 ±1.2) mmol/L,(4.1 ± 0.8) mmol/L,(4.1 ± 0.8) mmol/L respectively,according to the statistics results,the difference between SG group and G/C group respectively both remarkable (P ＜ 0.05).(4) The body weight,Lee's index,fat weight,and the fat weight of mass ratio in C group mother rats after lactation presented dressed compared with the SG group (P ＜ 0.05),and so as to the G group compared with the SG group (P ＜ 0.05).(5) In the female offsprings of G group,the birth weight was remarkably increased compared with the C group (P ＜ 0.05) ; the body weight of the female offsprings presented an increased trend compared with the C group since the 12 weeks,but had no statistical significance; there were significant differences of body weight between G group and C group since 15 weeks (P ＜ 0.05),and the trend kept up until 26 weeks; in the male offsprings of G group,the body weight on birth day and 4 weeks had a marked rise compared with the C group (P ＜ 0.05) ; and from then on,the body weight of the male offsprings presented an increased trend compared with the C group,but had no statistical significance until 26 weeks (P＞0.05).(6) In G group,the blood glucose on 30 min and 60 min of LGTT in female offsprings were increased than the C group since 20 weeks (P ＜ 0.05) ; the blood glucose of LGTT (30 min) still had a marked rise until 24 weeks (P ＜ 0.05) ; in G group,the blood glucose on 30 min of LGTT in male offsprings was remarkably incrcascd than the C group since 16 weeks (P ＜0.05) ; the blood glucose of LGTT (30 min) still had a marked rise until 24 weeks (P ＜ 0.05).(7) The blood pressure of male offsprings in G group had a marked rise on 12 weeks compared with the C group (P ＜ 0.05) ; from then on the blood pressure of G group kept up a rise trend until 26 weeks,but had no statistical significance (P ＞0.05).Conclusion The diabetic high-birth-weight rat model could be duplicated with STZ (25 mg/kg) once intrapertoneally on the first day of gestation,which were observed some evidently metabolic changes in weight,glucose tolerance and blood pressure.These results could represent an forward step in the clinical study of human gestational diabetes mellitus and their macrosomia babies,which may suffer some metabolic disease in their later life.

In order to investigate the distribution of Yersinia enterocolitica in Citellus dauricus plague focuses in Inner Mongolia,three different ecological environ/ments were chosen as the sampling area.Feces,tongue roots throat swabs,and intestinal contents of rodent,livestock,and poultry were separately collected,and different Y.enterocolitica strains were isolated,and identified.PCR analysis was conducted to detect the toxicity genes of Y.enterocolitica.Statiscal analysis was performed by chisquare test.Of the 3 260 samples,65 Y.enterocolitica strains were isolated and the overall detection rate was 1.99％.To include O ∶ 3/3,O ∶ 5/1A,O ∶ 4/4 serum biological type,the pathogenic strain of serotype O ∶ 3 and biological typt 3 carryinq toxicity genes ail,ystA,VirF yadA and rfbc was isolated from pigs in Citellus dauricus plague focuses,Inner Mongolia are the major carrier of pathogenic Y.enterocolitica distributed in three different ecological environment,and distributed mainly in agricultural area.

Objective To present our initial experience of using transumbilical multi-stab laparoscopic pyeloplasty(TMLP) as a treatment for the infants younger than 3 months with severe hydronephrosis caused by ureteropelvic junction obstruction (UPJO).Methods Seventy-two infants younger than 3 months with severe hydronephrosis caused by UPJO underwent TMLP from June 2010 to March 2013 in our center.The average age received operation was 34 days (7-87 days).The operative indications included:① prenatal diagnosis of Society of Fetal Urology Grade 4 hydronephrosis; ②ipsilateral differential renal function being less than 40％.Patients were followed up with physical examinations,ultrasound and radionuclide scans.Results The operations were successfully performed in all the 72 patients.Neither conversion nor additional trocars placement was required and there was no intraoperative complication.The average operative time was 75 min (range,53-118 min).The patients were followed up for 6-36 months (mean,12 months).The renal pelvic anteroposterior diameters were reduced and the renal functions were improved (P＜ 0.05).The anastomoses were proved to be patent and the renal parenchymal thickeness increased.In addition,the scars were barely noticeable.Conclusions TMLP for the infants younger than 3 months with severe hydronephrosis caused by UPJO is feasible,safe and less invasive.The cosmetic results are excellent.But the surgery must be operated by rich experienced surgeon.

Objective To investigate the prevalence and associated factors of fecal incontinence (FI) and urinary incontinence (UI) in postpartum Chinese women.Methods Questionnaires about FI and UI symptoms were completed via telephone interviews conducted within six months after delivery.Multi-variant Logistic analysis was applied for relation between delivery mode and FI or UI.Results (1) Two thousand and twelve postpartum women were admitted into this study,among which 14 (0.7％) had FI within 6 months after delivery.Logistic regression analysis showed that FI was significantly associated with forceps delivery (OR =20.09,95 ％ CI:3.64-110.90,P =0.000),and mediolateral episiotomy (OR=6.11,95％ CI:1.29-28.80,P=0.024).(2) Among the 2012 women,the prevalence of UI,stress urinary incontinence (SUI),urgent urinary incontinence (UUI)and mixed urinary incontinence (MUD was 10.04％ (n=202),8.15％ (n=164),0.94％ (n=19)and 0.94 ％ (n =19),respectively.Logistic regression analysis found that SUI prevalence was related to maternal age (OR =1.07,95％ CI:1.04-1.11,P =0.000),maternal weight before delivery (OR=1.04,95％ CI:1.02-1.06,P=0.001),neonatal head circumference (OR=1.20,95％ CI:1.05-1.39,P =0.010),mediolateral episiotomy (OR =4.96,95 ％ CI:3.05-8.07,P =0.0005 ),spontaneous vaginal delivery (OR=5.22,95％ CI:2.53-10.76,P=0.000) and forceps delivery (OR=9.20,95％ CI:4.07-20.79,P=0.000).UUI was related to maternal weight before delivery (OR=1.51,95％ CI:1.12-2.05,P=0.008).MUI was related to maternal weight before delivery (OR=1.06,95％ CI:1.00-1.11,P=0.049),duration of second stage of labor (OR=1.01,95％ CI:1.00-1.03,P =0.010),mediolateral episiotomy (OR =7.76,95％ CI:1.42-42.52,P=0.017) and forceps delivery (OR=15.21,95％ CI:1.61-143.44,P=0.018).(3) The prevalence of SUI was higher at 4 days and 42 days after delivery (7.95％ and 9.10％).Conclusions (1) F1 and UI prevalence is lower in this study than in other reports.(2) Vaginal delivery is a risk factor for women's FI and UI,especially forceps delivery and mediolateral episiotomy.(3) Maternal age,pre-delivery weight,newborn head circumference,spontaneous vaginal delivery,forceps delivery and mediolateral episiotomy might increase the risk of UI.

Objective To evaluate the efficacy and feasibility of laparoscopie intervention for congenital obstructive megaureter in children. Methods Eleven children with congenital obstructive megaureter(left in 4,right in 7)underwent laparoseopie ureteroplasty.One had congenital ureter oririce stenosis,9 had been diagnosed as simple congenital ureter orifice stricture,1 had recurrent ureter orifice stricture after open ureterovesical reimplantation.B-ultrasound and IVU showed severe hydronephrosis in 7 cases and moderate in 4. Results The operation was successful in all cases and none had urine leakage.The mean operating time was 103.0±35.3 min(range 70-190 min).The mean blood loss was 18.0±9.5 ml(range 10-40 ml)and the mean postoperative hospital stay was 8.0±1.4 d(range 7-10 days).The double J stent was removed 6 weeks after operation.The patients were followed up for 3-24 months(mean,6 months).Cystography showed no reflux in all cases during follow-up. Conclusion Laparoscopical ureteroplasty could be a minimal invasive,less suffering technique for the treatment of congenital obstructive megaureter in children.

OBJECTIVETo establish an indicator system of risk assessment for mechanical cuts, and to validate the system using examples.

METHODSAn indicator system was proposed by the expert investigation method. The index weight, expert authority coefficient, and degree of coordination were determined. The reasonability and stability of the expert questionnaire were evaluated by the reliability analysis. Some on-site examples were given to validate the indicator system.

RESULTSAn indicator system containing 3 first-class indicators, 10 second-class indicators, and 34 third-class indicators was obtained by screening indicators using the boundary value method and the assignment transformation method. The average expert authority coefficient was 0.79. The average expert coordination coefficient was 0.47. The overall reliability coefficient was 0.884. The scores obtained using the indicator system were significantly correlated with the actual injury results in six workplaces (r=0.866, P<0.01).

CONCLUSIONThe indicator system of risk assessment for mechanical cuts proposed in this study is reasonable and highly consistent with the actual injury results. However, this indicator system still needs further validation and optimization.

Objective To develop a staged laparoscopic training program for performing the ana-tomic retroperitoneoscopic adrenalectomy(ARA), and to determine its safety and feasibility. Me-thods Five young urological doctors without previous experience in open adrenalectomy were selected third period, trainees acted as camera holder first, then performed simple operations such as laparo-scopic renal cyst unroofing. Finally, they performed 30 ARA independently under the mentor's super-vision. Pheochromocytoma was ruled out for its large tumor size and potential cardiovascular risk. The patient selection criteria were the same as those of the initial 30 cases performed by the tutor. Preope-rative data of the initial 30 ARA performed by each trainee and tutor which included gender, age, body mass index, tumor size, tumor location and pathological diagnosis of tumor were compared between trainees and the tutor. The intraoperative and postoperative data of 150 ARA in the trainees were compared with the initial 30 ARA of the tutor. These included mean operative time, estimated blood loss, length of hospital stay, conversion rate, complication rate. Qualitative and quantitative data were compared between the groups using x2 and t test statistics methods by SPSS 12.0 for Windows, except operative time, which was from a nonnormal distribution. A P value less than 0.05 was consi-dered to be statistically significant. Results Preoperative data of the initial 30 ARA performed by each trainee were marched to those of the mentor (all P>0.05). All ARA were completed successful-ly. No procedure converted to open surgery. The median operative time of the trainees was 82 min (range 59-133 min), which was less than that of the tutor [132 min (range 73-230 min), P< 0.01]. And the trainees' learning curve was flatter than their tutor's. Estimated blood loss and length of hospital stay for the 5 trainees and the tutor were 62.2±22.0 ml, 4.8±1.3 d and 63.9±21.1 ml, 4.5±1.4 d respectively. There was no significant difference between these results (both P>0.05). No major complication was observed. Though the total perioperative complication rates were no diffe-rence between the trainees and their tutor (8.0% versus 13.3%, P>0.05), intraoperative minor complication rates of the trainees (1.3%) was less than that of the tutor (10.0%, P<0.05). Con-clusion The staged laparoscopic training is safe and feasible for young urological doctor to study in performing ARA.

Objective To investigate the current status of uterine rupture in pregnant women in China and analyze the impacts of different surgical histories on the pregnancy outcomes of pregnant women with uterine rupture. Methods The clinical records and pregnancy outcomes of 84 uterine rupture cases were collected and analyzed retrospectively. All cases came from 21 hospitals of 13 provinces (or municipality) in China, dated from January 1st 2014 to December 31st 2015. The total deliveries were 283 614 during the period. For 84 pregnant women with symptomatic uterine rupture, the impacts of different surgical histories on pregnancy outcomes were compared and the results were statistically analyzed.Results (1) Totally, 84 cases of uterine rupture were with symptoms and diagnosed. The median age, median gestational age were 32.5 years old (23.0-44.0 years old) and 35.7 weeks (9.3-41.0 weeks), respectively. The incidence of uterine rupture was 0.03%(84/283 614). The proportion of patients with cesarean section history was 66.7% (56/84). The proportion of patients with other gynecological surgery history was 20.2%(17/84). (2)Compared with the group of cesarean section history, the group with other gynecological surgery history had a significant increase in complete uterine rupture (16/17 vs 66.1%, P<0.05). Meanwhile, regarding the massive blood transfusion (red blood cell transfusion≥1 000 ml) in the treatment of uterine rupture, patients with other gynecological surgery history had significant more cases than the group with cesarean section history (9/17 vs 23.2%, P<0.05). There was no statistical difference for the other outcomes. Compared with the patients with cesarean section history, the rate of hysterectomy was higher in the group without major surgery history when uterine rupture happened (4/11 vs 7.1%, P<0.05). The incidence of postpartum hemorrhage significantly increased in patients without major surgery history, compared with those with cesarean section (8/11 vs 28.6%, P<0.05). There were no statistic difference for other outcomes.(3) Patients with uterine rupture in the non-abdominal pain group had a significantly increased risk of massive blood transfusion (5/8 vs 27.6%, P<0.05),and the incidence of neonatal asphyxia and hypoxic ischemic encephalopathy (4/7 vs 22.2%, P<0.05) were significantly increased. There were no significant difference between two groups regarding the other outcomes, such as preoperative diagnosis, complete rupture of uterus, hysterectomy, postpartum hemorrhage, shock, intrauterine fetal death or neonatal death, admission to neonatal ICU. Conclusions In addition to considering cesarean section history as one of the known risk factors, patients with non-cesarean section uterine surgery history should also be considered. The management of these patients should be strengthened during their pregnancy and delivery. There might be much more dangerous maternal and neonatal outcomes for the patients with uterine rupture who does not have any abdominal pain during pregnancy and delivery. To reduce the incidence of severe complications, uterine rupture should be diagnosed earlier. The early recognition and diagnosis of uterine rupture helps to improve maternal and neonatal outcomes.