In this study, it was found that in uncontrolled diabetes mellitus serum T3 and FT3J were decreased, and rT3. elevated. Fasting blood glucose and HbA1c were in negative correlation with T3 and FT3I. and in positive correlation with rT3. Serum TSH was negatively correlated with degree of retinopathy, 24h urinary protein, and duration of diabetes. TRH stimulation test showed low, delayed, or no response in 57% of patients tested, and the resultswere in negative correlation with fas'ting blood glucose and HbA1c. After 1-4 month trentment,blood glucose decreased, serum T3 increased, and rT3 decreased. It was believed that thyroid function test is of significance in evaluating the severity, prognosis, and effect of treatment in diabetes mellitus

This article described how simulation is used at Loma Linda University Medical Simulation Center.Detail description and examples were provided to help medical educators undemmnd the method of using the virtual simulator for teaching fast and efficient decision making skills at a high level of interactive medical education.

Objective To study the changing of vertebral body marrow fat fraction(FF) in different age and sex and the relation-ship between FF and bone mineral densities (BMD). Methods Eighty-five healthy volunteers aged from 21 to 70 years old and twenty patients with osteoporosis based on T score after dual X-ray absorptionmetry examination underwent proton magnetic reso-nance spectroscopy (MRS) in L_3 vertebral bodies. The volunteers were divided into five groups according to the age(10 years and 16～18 cases in each group). Results The FF values in 21～30 years group,31～40 years group,41～50 years group,51～60 years group , >60 years group and the osteoporotic group were 30.7%±4.4%, 35.5%±6.8% , 41.9%±6.6%, 46.8%±5.5%, 51.7%±5.2% and 59.2%±7.4%, respectively. The FF values in L_3 vertebral bone marrow in men were high than that in women in the same age group (P<0.05) except >60 years group. There was negative correlation between marrow fat content and T score in osteoporotic group(γ=-0.6, P<0.01). Conclusion The vertebral marrow fat content in healthy adults was significantly in-creased with the aging. MRS may be used as a new way to evaluate the physiological and pathological process of bone marrow.

The book Acupuncture-moxibustion Clinical Skills Training is one of "Twelfth Five-Year Plan" in novative teaching materials, which is published by People's Medical Publishing House. Through learning the first half of the book commonly used needling and moxibustion techniques, it is realized that the selection of book content is reasonable and much attention is paid to needling and moxibustion techniques; the chapter arrangement is well-organized, and the form is novel, which is concise and intuitive; for every technique, great attention is paid to standardize the manipulation procedure and clarify the technique key, simultaneously the safety of acupuncture and moxibustion is also emphasized. The characteristics of the book, including innovativeness, practicability, are highlighted, and it greatly helps to improve students' clinical skills and examination ability.
Acupuncture ; education ; standards ; Acupuncture Therapy ; instrumentation ; methods ; standards ; Books ; Clinical Competence ; standards ; Humans ; Moxibustion ; instrumentation ; methods ; standards ; Reference Standards ; Teaching ; standards ; Teaching Materials ; standards

Objective To investigate the minimal invasive management of cystitis glandularis with invasion of the ureteric meatus.Methods The clinical data of 18 cases were reviewed.Among the 18 cystitis glandularis patients,12 cases were invasion of bilateral ureteric meatus and 6 of unilateral ureteric meatus.Operation or drug treatment was performed on the diseases that can cause cystitis glandularis such as bladder stone,bladder neck stegnosis,external urethral meatus stegnosis and benign prostate hyperplasia.Sensitive antibiotic was administrated in all cases.After placing ureter catheter,transurethral plasma electro-resection was carried out in five patients whose ureteric meatus could be identified.In addition,of thirteen patients with ureteral orifice unable to be identified,there were ten cases with normal renal function,mitomycin was injected under affected membrana mucosa,and then the patient with ureteral orifice identified underwent transurethral plasma electro-resection after placing ureter catheter.On the other hand,the patient whose ureteral orifice still could not be recognized undertaken transurethral electro-resection at first,during which the ureter catheter was put once ureteral orifice had been detected,otherwise,the ureter catheter should be placed through cystoscope if nephritic colic emerged and hydronephrosis aggravated after operation.In those patients with kidney dysfunction,the ureter catheter was put by ureter discission or ureter replantation at first,the transurethral electro-resection could not be executed until the renal function recovered.Following all these procedure above,bladder instillation of drugs regularly,anti-infection and symptomatic treatment were administrated.Results One patient combined with bladder adenocarcinoma received cystectomy,of the other patients,six cases recurred and underwent electrotomy again resulting in no relapse.All nephrohydrops vanished or relieved obviously,nevertheless,urinary tract infection,haematuria and bladder-ureter backstreaming as the cardinal complication developed in some cases.Conclusion In the management of cystitis glandularis encroaching ureteric meatus,total or partial cystectomy can be avoided if ureter draining freely can be ensured,motivation removal,antiinfection,injection of drug under mucosa and preoperative diuresis conduce to the achievement of ureter catheter placing,transurethral plasma electro-resection is still effective methods in treating these cystitis glandularis.

Objective:To investigate the reason for the adhesion of vocal cord after CO_2 Laser laryngeal surgery.Method:One hundred and nineteen patients who were untaken CO_2 Laser laryngeal microsurgery.Result: Among 119 cases,9 cases of bilateral vocal cord paralysis, 42 cases of vocal cord polyps and 3 cases of precancerous laryngeal lesions did not show vocal cord adhesion after CO_2 Laser laryngeal microsurgery.Contrarily, one of 5 cases with laryngeal stenosis, 5 of 41 cases with laryngeal papilloma and 6 of 19 cases with laryngeal carcinoma shew the adhesion of vocal cord after CO_2 Laser laryngeal microsurgery.Conclusion:Through selecting the appropriate patient and surgery spot, processing correctly during and after surgery, using the suitable dosage of laser and reducing the heat radiation, the adhesion of vocal cord can be avoided after CO_2 Laser laryngeal surgery.

Objective To explore the significance of urodynamics detection in benign prostatic hyperplasia (BPH) patients with cerebral vascular accident. Methods The results of urodynamics were detected in 60 BPH patients with cerebral vascular accident (research group) and 60 simple BPH patients (control group), and the results were compared. Results The levels of bladder compliance (BC), maximum bladder capacity (MCC), maximum urinary flow rate (Qmax), detrusor pressure before voiding (Pdet), maximal urethral closure pressure (MUCP), functional urethral length (FUL) in research group were significantly lower than those in control group:(25.0 ± 4.4)ml/cmH2O (1 cmH2O=0.098 kPa) vs. (34.0 ± 5.9) ml/cmH2O, (203.0 ± 16.8) ml vs. (256.0 ± 20.3) ml, (6.70 ± 0.25) ml/s vs. (11.10 ± 0.43) ml/s, (81.0 ± 13.6) cmH2O vs. (108.0 ± 20.2) cmH2O, (60.0 ± 9.8) cmH2O vs. (88.0 ± 12.2) cmH2O, (3.0 ± 0.5) cm vs. (5.2 ± 0.8) cm, P < 0.05. The level of postvoid residual volume (PRV) in research group was significantly higher than that in control group:(83.0 ± 9.4) ml vs. (48.0 ± 8.3) ml, P<0.05. The rate of low compliance bladder and unstable bladder in research group were significantly higher than that in control group:63.3%(38/60) vs. 25.0%(15/60), 66.7%(40/60) vs. 28.3%(17/60), P<0.01. Conclusions Cerebral vascular accident can increase the bladder dysfunction of patients with BPH .

Objective To investigate the clinical effect of elastics drawing off balloon catheter for 24 hours on preventing bleeding after transurethral plasmakinetic resection of prostate (TUPKRP).Methods Seven hundred patients with benign prostatic hyperplasia (BPH) underwent TUPKRP in the Eighth People's Hospital of Shanghai from Jan.2005 to Jun.2013 were randomly divided into control group (298 cases) and experiment group (402 cases).Patients in control group after transurethral resection of the bladder were given treatment as follow:the bladder was placed with F22 cavity catheter,which were fixed on the medial femoral traction;prostate wound edge was pressed for 2-3 d and saline continuous irrigated bladder for avoiding infection.Patients in experiment group were given the same treatment with control group beside prostate wound pressed for 24 h.The days (1st,3rd,5th) of bleeding after operation,cases of hematuria turn clear,cases of postoperative blood transfusion and operation bleeding were recorded.Results Cases of hematuria disappeared postoperation at 1 st,3rd,5th days after operation were 52,42,24 cases in control group and 34,22,10 cases in experiment group.The differences were significant(x2 =6.608,9.279,7.624 ;P =0.010,0.002,0.006).Cases of blood transfusion and reoperation in experiment group were 6 and 2 cases,lower than that in control group(15,9 cases ; x2 =4.955,5.264 ; P =0.026,0.022).Conclusion The method of elastics drawing off balloon catheter for 24 hours improved the effect of preventing bleeding after TUPKRP.

Objective To study the influence of post-void residual volume on prostate specific antigen (PSA) in patients with benign prostatic hyperplasia (BPH).Methods One hundred and sixty BPH patients who diagnosed by postoperative pathologic manifestations were selected.The patients were divided into 4 groups according to post-void residual volume with 40 cases each:non post-void residual volume (post-void residual volume ＜ 60 ml) group,less post-void residual volume (60 ml≤post-void residual volume ＜ 120 ml) group,middle post-void residual volume (120 ml ≤post-void residual volume ＜ 180 ml) group,mass post-void residual volume (post-void residual volume ≥180 ml) group.The serum PSA levels of 4 groups were observed.Results The PSA level in mass post-void residual volume group [(8.52 ± 6.72) iμ g/L] was significantly higher than that in non post-void residual volume group [(5.26 ± 4.16) μ g/L] and less post-void residual volume group [(5.93 ± 5.20) μ g/L],there were statistical differences (P ＜ 0.05),there was no statistical difference between non post-void residual volume group and less post-void residual volume group (P ＞ 0.05).Conclusions The serum PSA level in BPH patients with non post-void residual volume has no change,while the serum PSA level in BPH patients with mass post-void residual volume is significantly elevated.

Objective To investigate the diagnostic value of texture analysis derived from conventional MR imaging in differentiating benign and malignant breast lesions. Methods Thirty-six patients with malignant breast lesion and 33 patients with benign breast lesion were retrospectively analyzed in our study. All patients underwent conventional MR imaging including axial T1WI, T2WI, and contrast-enhanced T1WI before surgery. Texture features were calculated from manually drawn ROIs by using MaZda software. The feature selection methods included mutual information (MI), Fishers coefficient, classification error probability combined with average correlation coefficients (POE + ACC) and the combination of the above three methods(FPM). These methods were used to identify the most significant texture features in discriminating benign breast lesion from malignant breast lesion. The statistical methods including raw data analysis (RDA), principal component analysis (PCA), linear discriminant analysis (LDA) and nonlinear discriminant analysis (NDA) were used to distinguish malignant breast lesion from benign breast lesion. The results were shown by misclassification rate. Results In the three kinds of sequences, the texture features for differentiating malignant breast lesion and benign breast lesion were mainly from T2WI which had the lowest misclassification rate 4.35%(3/69). The misclassification rates of the feature selection methods were similar in MI, Fisher coefficient and POE+ACC (15.94%to 56.52%for MI;17.39%to 56.52%for Fisher coefficient and 17.39%to 56.52%for POE+ACC). However, the misclassification rate of the combination of the three methods (4.35%to 53.62%for FPM) was lower than that of any other kind of method. In the statistical methods, NDA (4.35% to 27.54%) had lower misclassification rate than RDA (33.33% to 56.52%), PCA (33.33% to 53.62%) and LDA (15.94% to 44.93%). Conclusion Texture analysis of conventional MR imaging can provide reliably objective basis for differentiating benign from malignant breast lesions.