Objective To study application of hematocoelia reinjection in abdominal injury with massive hemorrhage and anemia ,and to estimate the impact of salvaged autotransfusion on blood routine and blood coagulation of patients.Methods In 75 patients with intra-abdominal injury bleeding anemia undergoing autologous hematocoelia reinfusion,compare the anemia index and coagulation indexes before and after surgery to evaluate the therapeutic effect.Results Among 75 cases,1 cases died of brain injury,the other 74 cases were cured.After the second days of review,red blood cell,hemoglobin,hematocrit,platelet were elevated,compared with preoperative,the differences were statistically significant(all P<0.01).Comparison of each index function and coagulation before operation ,the differ-ences were statistically significant (all P>0.05).Conclusion Salvaged autotransfusion can improve anemia prompt-ly without any impact on coagulation function in rescuing abdominal injured patients with massive hemorrhage and a -nemia.The treatment is effective .It has an important application in primary hospital .

Objective To study the safety and effectiveness finasteride combined with 1470 nm semiconductor laser vaporization and resection for moderate to severe benign prostatic hyperplasia (BPH). Methods A total of 110 consecutives from January to December 2015 were divided randomly into control and observation groups and each of 55 cases; the patients in control group received finasteride combined with transurethral prostatectomy (TURP) and they in observation group adopted finasteride combined with 1470 nm semiconductor laser vaporization and resection, then to compare the differences of surgical success rate,complications rate,mean operation time,blood bloss during and after operation, indwelling catheter time,prostate volume before and after operation; the follow-up time was 12.0 months, the differences of international prostate symptom score (I-PSS), Quality of life score (QOL), peak flow rate (Qmax) peak flow rate (Qmax) and post-void residual (PVR). Results The surgical success rate in the two groups were no statistical difference, the complications rate in observation group was significantly lower (P<0.05). The mean operation time and indwelling catheter time in the two groups were no statistical difference, while the total blood bloss and prostate volume after operation in observation group were both less, and the difference of prostate volume was more (P<0.05). The I-PSS and PVR were lower, QOL and Qmax higher in the two groups after operation, what'more, there were more improvements in observation group (P<0.05). Conclusion It is more prior to finasteride combined with 1470 nm semiconductor laser vaporization and resection for moderate to severe BPH on the Safety and effectiveness than TURP.

Objective To investigate the therapeutic effect of mitoxantrone on prostate cancer and the effect of relieving pain of patients.MethodsRetrospective analysis of clinical data of patients with bone pain in April 2010 to May 2016 year in our hospital for treatment of prostate cancer, according to their treatment divided into control group and observation group, the control group was 40 cases given docetaxel treatment, the observation group was 30 cases treated with mitoxantrone.Compared the pain relief, sleep quality, tumor markers and the incidence of adverse reactions of the two groups.ResultsAfter treatment, the observation group pain control rate was 96.67%, significantly higher than the control group, the difference was statistically significant (P<0.05);the observation group sleep quality was significantly better than the control group, the difference was statistically significant (P<0.05);the observation group cPSA and CEA were lower than those of control group, the difference was statistically significant (P<0.05).Two groups of patients with bone marrow suppression, nausea and vomiting, rash and liquid retention rate had no significant difference (χ2=0.648, P=0.421).ConclusionMitoxantrone has better therapeutic effect on prostate cancer, can significantly relieve the situation and quality of sleep in patients with bone pain.

Objective To investigate the effect of the treatment of prostatitis and NIH-CPSI score and clinical therapeutic effect of prostate cancer treated with prostaglandin E and alpha blockers.MethodsThe clinical data of patients with prostatitis treated in The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from March 2015 to August 2016 in were retrospectively analyzed.The patients were divided into control group and observation group.The control group was treated with the treatment of the first aid, while the observation group was treated with the combination of the first and the second.The therapeutic effects of the two groups were observed and compared between the two groups before and after treatment NIH-CPSI score, prostate fluid routine, cytokine levels and adverse reactions.ResultsIn the observation group, the treatment efficiency was 97.78%, significantly higher than the control group (85%), the difference was statistically significant (χ2=4.575, P=0.032);Two groups of patients before treatment NIH-CPSI score no difference, after treatment, the observation group of pain or discomfort, voiding symptoms, quality of life and total score were lower than the control group(P<0.05);Two groups of patients before treatment, no difference in the prostatic fluid, after treatment, the observation group was higher than the control group, the number of white blood cells was lower than the control group(P<0.05);There was no difference in the levels of cytokines before and after treatment in the two groups.After treatment, the levels of TNF-α, IL-6 in the observation group were lower than those in the control group(P<0.05).There were no obvious adverse reactions such as liver and kidney injury during the treatment of two groups of patients.ConclusionThe treatment of prostatitis combined with alpha blocker has good therapeutic effect, can significantly improve the clinical symptoms, and has good application value.

Objective To investigate clinicopathological characteristics of recurrent endometriosis and outcomes of secondary surgery.Methods From Jan.2003 to Dec.2008,69 cases with recurrent endometriosis operated by the same senior gynecologist in Peking Union Medical College Hospital were studied retrospectively in order to summarize clinicopathological characteristics and clinical outcomes.In prior surgery,both ovaries were involved in 29 cases (42％,29/69),and unilateral ovarian endometriomas were found in 40 cases ( 58％,40/69),including 19 cases (48％,19/40) with left lesions and 21 cases (52％,21/40) with right lesions.After first surgery,57 cases presented recurrent pelvic cystic masses and 12 cases presented moderate to severe pain without pelvic mass.Results The median recurrence interval was 38 ( 1 - 144) months.Among 57 cases with recurrent pelvic masses,bilateral ovarian endometiomas recurred in 24 cases at median recurrence interval of 31 months.Unilateral ovarian endometrioma recurred in 33 cases at recurrence interval of 39 months.There was no significant different recurrence period between blilateral and unilateral recurrent ovarian mass ( P =0.452).The recurrent rate of left and right side ovarian lesion was 77％ (37/48) and 68％ (34/50 cases),respectively,which did not reach statistical difference (P=0.396).Among 12 recurrent cases with pure pelvic pain,10 cases were founded combined with adenomyosis ( AM),of which 4 cases had deep infiltrated endometriosis (DIE).Compared with the 40 cases of simple ovarian endometriomas,29 cases complicated by DIE and (or) AM had longer operation time (75.1 min vs.49.9 min,P=0.017) and more blood loss (114.9 ml vs.38.4 ml,P＜0.05).In those 69 recurrent endometriosis patients,the median period of following-up was 32 months (3 months to 8 years).Six cases showed recurrent disease again at median recurrence interval of 3 years ( 6 months 6 years).Thirty-eight cases had expecting childbearing,however,only 4 women underwent childbirth.Conclusions The rate of clinical diagnosis of recurrent endometriosis is quite high.Pain is mostly associated with AM.The major difficulty and challenge of secondary surgery was ovarian endometrioma combined with DIE or AM.Prognosis of recurrent endometriosis is not optimistic after secondary surgery.

Objective To detect the total colon transit time (CTT) and segmental CTT of patients with chronic constipation and explore the clinical significance. Methods Colon transit study and defecography(DFG) were performed on 60 patients with chronic constipation. These patients were divided into 3 groups: group Ⅰ, 19 patients with slow transit constipation based on low stool frequency and normal DFG, group Ⅱ, 22 patients with rectal intussusception diagnosed by DFG and group Ⅲ, 19 patients with external rectal prolapse or puborectal muscle syndrome based on the results of DFG. Results Group Ⅰ showed increased total CTT (mean, 96.2 h) and segmental CTT, right colon, 35.3 h (36.7%), left colon, 30.8 h (32.0%), rectosigmoid, 30.1 h (31.3%). Group Ⅱ had normal mean total CTT (57.8 h) and a relative decrease in rectosigmoid CTT [mean, 13.8 h (23.9%)]. In group Ⅲ, patients showed elevated total CTT(mean, 175.1 h) and rectosigmoidal CTT [mean, 115.8 h(66.1%)]. There were significant differences in mean total CTT and rectosigmoidal CTT among the 3 groups ( P

Objective To investigate the relationship between degree of endometrioma adhesions and clinical feature, surgical treatment and postoperative recurrence. Methods From Jan 2003 to Mar 2008, 662 patients with endometrioma undergoing laparoscopic ovarian endometrioma excision in Peking Union Medical College Hospital were studied retrospectively. All patients were classified into four groups according to the extent of adhesions: 31 cases in none adhesions group, 123 cases in mild adhesions group (filmy thickness, avascular, easily separated adhesions), 310 cases in moderate adhesions group (less than a half of ovary was adjacent to dense thickness adhesions which was difficult to separate, or above a half of ovary were adjacent to filmy thickness adhesions) and 198 cases in severe adhesions group (above a half of ovary was adjacent to dense thickness, well vascularized adhesions which was difficult to separate, and always involved the other pelvic organs, observed angiogenesis). The comparison of degree, characteristics, period of pain, lab test, surgical management and postoperative recurrence was performed among those above groups. In the mean time, risk factors and multinomial logistic regression were analyzed. Results (1)Clinical characteristics: The incidence of patients with dysmenorrhea, dyspareunia, straining feeling in anus, chronic pelvic pain and the level of CA125 (>35 kU/L) was remarkably higher in moderate-to-severe adhesion groups than in none-to-mild adhesions groups (P=0.000, 0.000, 0.001, 0.006 and 0.000, respectively). Infertility rate were significantly higher in severe adhesions group(15.7%,31/198) than none adhesions group(3.2%,1/31), mild adhesions group(11.4%,14/123) and moderate adhesions group(9.7%,30/310, OR=1.728, P<0.05).(2)Operating time and blood loss: Operating time of each groups was as followed: (37±15) min in none adhesions group, (42±19) min in mild adhesions group, (50±20) min in moderate adhesions group and (63±22) min in severe adhesion group. Blood loss was (23±12) ml in none adhesion group, (31±27) ml in mild adhesion group, (40±32) ml in moderate adhesion group and (70±67) ml in severe adhesions group. Thicker adhesions result in longer operation time and more blood loss. (3)Combined with other disease: The ratio of patients who combined with adenomyosis or deeply infiltrating endometriosis in moderate-to-severer adhesion groups was higher than patients in none-to-mild adhesions groups (OR=3.466, P=0.000). (4) Postoperative recurrence: It was categorized into recurrence of pain and cyst. Moderate-to-severe adhesions was related to higher recurrence rate of pain (OR=1.685,P=0.046), but was irrelevant to recurrence of cyst. Conclusion The more extent of endometrioma adhesions was related to severer pelvic pain symptoms, longer operating time and more blood loss. Postoperative pain recurrence rate was observed in moderate-to-severe adhesion group. Extent of adhesions was irrelevant to cyst recurrence.

Objective To study the significance of pain symptoms and physical signs to diagnosis of deeply infiltrating endometriosis (DIE).Methods Totally 500 patients with laparoscopic diagnosis of endometriosis were studied retrospectively and divided into two groups depending on the existance of DIE.The pain symptoms and gynecological physical signs were recorded detail,and the correlation with diagnose of DIE were analyzed.Results (1) The significance of pain symptoms:the sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV) and OR,95％ CI of each pain symptom were:dysmenorrhae (90.5％,37.2％,59.6％,79.3％,5.66,3.46-9.28),chronic pelvic pain (35.2％,82.6％,67.4％,55.4％,2.58,1.70-3.91),dyspareunia (46.2％,80.6％,70.7％,59.6％,3.56,2.39-5.32),dyschezia (51.0％,73.7％,66.5％,59.5％,2.91,2.00-4.24),respectively.(2) Pelvic physical examination:the sensitivity,specificity,PPV and NPV of each physical sign were:fixed uterine:73.6％,71.2％,79.5％,64.0％; fixed ovarian cyst:94.1％,20.3％,63.3％,70.0％; uterosacral ligaments nodule:47.1％,97.5％,96.6％,54.9％; uterosacral ligaments nodule with tenderness:81.7％,75.0％,83.1％,73.2％; rectovaginal septum nodule:32.2％,100.0％,100.0％,49.4％; rectovaginal septum nodule with tenderness:32.2％,100.0％,100.0％,49.4％; blue nodule in posterior vaginal forni:14.9％,100.0％,100.0％,43.7％.Conclusions In the symptoms,the dysmenorrheal has the highest sensitivity and NPV for the diagnosis.And chronic pelvic pain has the highest specificity,and dysparaunia has the highest PPV for the diagnosis.In pelvic vaginal examination,fixed uterine,fixed ovarian cyst and the nodule on uretosarcal ligment and rectovaginal septum with tenderness,the blue lesion on posterior fornix have the strong significance for DIE.So record the symptom detail and careful digital vaginal examination,especially the vaginal-recto-abdominal examination could improve the diagnosis DIE obviously before procedure.

OBJECTIVE:To study the influencing factors of protocol deviation in drug clinical trial implementation,and pro-vide reference for improving the quality of drug clinical trial. METHODS:Quality verification was conducted for the drug clinical trial projects in the First Affiliated Hospital of Chongqing Medical University during 2010-2016,and protocol deviations in each year were retrospectively studied,classified and analyzed. Category,frequency,international and domestic pilot projects and the differences of protocol deviation after full-time research nurse participating in trail management were explored,and the measures were put forward. RESULTS:27 drug clinical trials were implemented in our hospital during 2010-2016,including 949 cases,176 cases with protocol deviation,accounting for 18.55％. Deviation protocol in drug clinical trial was decreased year by year for 7 years. The categories were mainly incompleteness of observation/records (30.11％),checking omission/broaden the window(28.41％),adverse drug events and improper combined medication (14.20％) and omission in drug management (11.93％). The proportion of protocol deviation with full-time research nurse participated was lower than the projects without full-time research nurse(11.11％ vs. 28.67％,P<0.01),and proportion of deviation protocol in international multi-center project was lower than the domestic projects(6.60％ vs. 28.84％,P<0.01). CONCLUSIONS:It is suggested to pointedly strengthen the weak links of drug clinical trial. For example,clinical trial institutions should establish the clinical trial data retention system,electronic data should be timely backed up in a different places,etc. Besides,clinical trial institutions should equip professional full-time research nurses as much as possible,learn the rigorous scientific experimental design,standard operational procedures and the authenticity of data pro-cessing from the international multi-center clinical trial projects to effectively reduce the incidence of deviation protocol and im-prove the quality of drug clinical trials.

AIM:To observe the effect of atorvastatin(ATV) on myocardial ischemia-reperfusion injury and the role of inducible nitric oxide synthase (iNOS). METHODS: The rabbits were randomly divided into control group, ATV group, ATV+S-Methylisothiourea sulfate (SMT) group, SMT group. All rabbits were subjected to 40 min ischemia and 240 min reperfusion. The hemodynamic variables, CK-MB, LDH-1 and nitric oxide synthase were detected after reperfusion. RESULTS: LVDP and +dp/dtmax decreased by 24.6% and 35.3% respectively following ischemia-reperfusion. Pre-treated by ATV (10 mg?kg-1?d-1) for three days, LVDP and +dp/dtmax decreased by 21.7% and 41.3%, CK-MB and LDH-1 by 31.4% and 19.1% and iNOS increased to 102.6%. The reduction of LVDP and +dp/dtmax, CK-MB, LDH-1 and iNOS in ATV+SMT group was no statistically significant with those in control group. CONCLUSION: ATV pretreatment protected myocardial ischemia-reperfusion injury by upregulating iNOS.