Objective To evaluate the effects of urodynamic studies on diagnosis and treatment of female stress urinary incontinence (SUI). Methods Urodynamic studies including the determination of stress leakage spot pressure were performed in 20 cases of SUI.Of them 6 cases (30%) had detrusor instability.Based on the types of SUI pathogenesis,7 cases were of Type Ⅲ,10 cases of mixed type (Type Ⅲ/Type Ⅱ) and 3 cases of Type Ⅱ.Of the 20 cases,16 underwent operation,including modified Gittes suspension in 12,sling with polyester pieces in 3 and MMK plus posterior vaginal wall repair in 1. Results The 16 operatied patients were followed up for 8～40 months(mean,31 months).The patients undergoing MMK or Sling operation were cured.But 3 patients (1 of Type Ⅲ and 2 of Type Ⅲ/Ⅱ) undergoing modified Gittes suspension had relapse (recurrence rate,25%). Conclusions Urodynamic studies are important to the diagnosis and differential diagnosis of SUI,and are indicative for choice of operation approaches.

Objective: To study the effects of retinoids (retinol? retinoic acid? retinyl acetate) in vitro on the production of interleukin 1 (IL-1)? interleukin 2 (IL-2) of peripheral blood mononuclear cells (PBMC) from the children with recurrent respiratory infection (RRI). Methods: The activities of IL-1? IL-2 of the PBMC from RRI children and the changes of IL-1? IL-2 activities after cultured with 10 -9 mol/L retinoids were measured. Results: The activities of IL-1? IL-2 of PBMC from RRI children were lower than normal control and could be restored to normal level after cultured with retinoids. Conclusion: The production of IL-1? IL-2 of PBMC from RRI children can be enhanced by retinoids and restored to normal.

Objective To explore the experience in diagnosis and treatment ot primary transitional cell carcinoma of prostate for the early and accurate to diagnosis and treatment.Methods The clinical data and features of 3 cases were retrospectively reviewed.Results All patients were diagnosed as primary transitional cell carcinoma of prostate.Two cases were advanced tumor.The preoperative examinations (ultrasound and serum,PSA) have failed to accurately indicate the diagnosis.All of them were confirmed by pathological examination.1 case lost follow-up,1 case performed TURP + chemotherapy through intravesical administration have survived 17 months respectively till today.The other case has already survived 2 months postoperatively but with lumbar spine bone metastasis.Conclusions Early diagnosis of primary transitional cell carcinoma of prostate is difficult.The diagnosis of the disease depends on the transrectal needle biopsy of the prostate or the specimens of the prostate after the Urethroscopy.Because of the prognosis is bad,and prone to pathological missed diagnosis or misdiagnosis.Need to exclude multicentric lesions and mixed tumor and choice of treatment method.

Objective To investigate the nutritional risks, undernutrition, and nutritional support among inpatients in tertiary hospitals in Tianjin using Nutritional Risk Screening 2002 (NRS2002). Methods Inpatients in six departments in two tertiary hospitals in Tianjin (Tianjin Nankai Hospital and Tianjin Chest Hospital ) were consecutively enrolled from March 2005 to March 2006. Their nutritional risks were screened using NRS 2002, and the nutritional support was investigated. Results A total of 1200 inpatients received nutritional screening, and 93.0% of them underwent NRS 2002 scoring. The prevalence of undernutrition was 9. 8% and the prevalence of nutritional risk was 42. 8%. Of these patients, 241 patients (46.4%) with NRS2002≥3 received nutrition support, and 244 patients (35.9%) with NRS2002 ＜3 received nutritional support Conclusions NRS2002 is suitable for nutritional risk screening among inpatients. Inpatients usually have nutritional risks or undernutrition. However, physicians at different levels in different regions have different awareness of such risks or conditions, and the clinical application of nutritional supports sometimes are inappropriate.

Objective To investigate the effects of functional electrical stimulation (FES) on motor function and the expression of bromodeoxyuridine (Brdu) + and glial fibrillary acid protein (GFAP) + in the subventricular zone (SVZ) of rats with acute cerebral infarction,and to explore it's mechanism. Methods A rat model of cerebral infarction was established using Longa's technique for middle cerebral artery occlusion (MCAO) with an intraluminal filament.The rats were randomly divided into a FES group,a placebo stimulation group and a control group.In each group,rats were randomly allocated into 1 d,3 d,7 d and 14 d subgroups (6 rats/subgroup).Superficial electrodes were pasted on the paralyzed forelimbs of rats in the FES group for connecting with the FES instrument,and FES treatment was carried out with a current of 4-5 mA for 15 min on the third day after the MCAO operation to produce extension of the wrist and the digits of the paralyzed forelimb.The rats in the placebo stimulation group were pasted with electrodes,but no FES was administered and they received no other treatment.Neurological deficits were evaluated using the modified neurological severity score (mNSS) before treatment and on the 1 st,3rd,7th,and 14th day after treatment. BrdU and GFAP positive cells in the SVZ were detected by immunofluorescence techniques.Results After 7 or 14 days the motor function of rats in the FES group had improved significantly compared with the placebo stimulation and control groups.Compared with the other two groups,the expression levels of BrdU+ and GFAP+ cells in the ischemic SVZ in the FES group were significantly higher at the 3rd,7th and 14th day.Conclusion FES can improve motor function after acute cerebral infarction and also promote the proliferation and differentiation of neural stem cells in the SVZ.

Objective In order know the clinical effects of vitamin B1 point injection combined with Chinese manipulation and Qi Gong therapy on the postoperative urinary retention after hemorrhoid operation. Methods Totally 150 patents with postoperative urinary retention after hemorrhoid operation were divided into the experimental group and the control group with 75 cases in each group randomly.The experimental group were treated with vitamin B1 injection at San Yin Jiao point by disposable ascepfic syringe,at the same time Chinese manipulation and Qi Gong therapy were used to masage the bladder in the lower abdomen.The tradi- tional nuusing cares,such as changes of body position,induction by bicker and foment by hot water bag,were used in the conutrol group.The improving conditions of postoperative urinary retention was compared between them.Results The total effective rate was 93%(44 cases with marked effect,26 cases with drect)in the cxperimental group and 53%(17 cases with marked effect,23 cases with effect)in the control group respectively,with a very significant difference between the two groups,X2=31.7,P＜0.01.The experimental group was significantly better than that of control group in the time of uresis after surgery,P＜0.01.Conclusions Vitamin B1 point injection combined with Chinese manipulation and Qi Gong therapy is an effective mursing measure to alleviate urinary retention after henmrrhoid operation.

Objective To assess the relationship between arterial stiffness and heart function in patients with hypertension using ultrasonography. Methods A total of 167 patients with hypertension and 165 controls were enrolled, and the parameters of arterial stiffness and heart function were measured and calculated. The results were analyzed and compared. Results The ratio of peak early-diastolic mitral orifice flow velocity and peak early-diastolic mitral annular velocity in left ventricular posterior wall (E/e), and Tei index were significantly higher in hypertension group than in controls(E/e: 10.92±3.14 vs. 7.70 ±1.56, Teiindex: 0.58±0.13 vs. 0.45±0.09, both P＜0.05), but there was no significant difference in ejection fraction (EF) between the two groups. In hypertension group, the parameters of arterial stiffness including β value, pressure-strain elastic modulus (Ep), pulse wave velocity (PWVβ) and arterial compliance were 11.0±5.2, (172.6±83.8)kPa, (7.8±1.6) m/s and (0.6±0.2) mm2/ kPa. In control group, the corresponding data were 7.5±3.0, (97.1±45.4) kPa, (5.9±1.3) m/s and (0.8±0.3) mm2/kPa. There were significant differences between the two groups (all P＜0.05). The E/e was positively correlated with Ep and PWVβ(γ=0.316 and 0.296, both P＜0.05). The Tei index was positively correlated with Ep,augmentation index (AI) and PWVβ(γ=0.278, 0.300 and 0.323, P＜0.05-0.01). There was no significant correlation between EF and arterial stiffness. Conclusions The arterial stiffness and damage of heart function can result from hypertension. The arterial stiffness can be one of monitoring indexes for the heart function damage in early time.

Objective To explore the method for detecting the connexin 43(Cx43) in detrusor of bladder in rats with detrusor instability.Methods The model of rats with detrusor instability was established.Ten rats in unstable bladder group were determined by filling cystonetry method controlled by 10 normal rats.The fluorescein isothiocyanate(FITC) was used to label the Cx43 and the tritin conjugated rhodamine was used to label the cell membrane of detrusor muscle.The Cx43 and the cell membrane of detrusor muscle were detected by laser scanning confocal microscopy(LSCM),and the images were analyzed by the image analysis program.Results The distinct images of Cx43 and cell membrane of detrusor muscle could be obtained by the LSCM.The expression of Cx43 and pixel density were increased significantly in rats of unstable bladder group than those of the control group(all P

Objective:To investigate the current situation of telephone cardiopulmonary resuscitation (T-CPR) in China, and analyze the reasons for the low implementation rate of T-CPR.Methods:This was a multicenter cross-sectional survey. Twenty cities were selected from six geographical regions of China by convenient sampling method. Anonymous online electronic questionnaires were sent to emergency medical service staffs in each city. All respondents were divided into the routine T-CPR group and control group. Student's t test and Chi-square test were used to analyze the difference between groups. Multivariate logistic regression was used to analyze the influencing factors of T-CPR. Results:⑴A total of 1 191 questionnaires were collected. 80.94% of respondents knew T-CPR. Nine hundred and sixty respondents, who knew T-CPR and completed the questionnaires, were included in the study, and were divided into the routine T-CPR group ( n=401) and control group ( n=559). Nine hundred and thirty-nine (97.81%) responders believed that T-CPR should be implemented for cardiac arrest patients that could be confirmed by telephone.⑵Four hundred and one (41.77%) responders routinely implemented T-CPR. Among them, 237 (24.68%) responders always did and 164 (17.08%) responders often did. ⑶Multivariate logistic regression analysis showed that male ( OR=1.787, 95% CI: 1.235-2.587, P=0.002), age ( OR=1.025, 95% CI: 1.004-1.047, P=0.020), clinical medicine background ( OR=2.926, 95% CI: 1.387-6.171, P =0.005), dispatcher ( OR=5.305, 95% CI: 3.463-8.126, P<0.01), using medical priority dispatch system (MPDS) system ( OR=1.941, 95% CI: 1.418-2.656, P<0.01), and T-CPR policy or procedure ( OR=3.879, 95% CI: 2.652-5.674, P<0.01) were favorable factors for T-CPR. ⑷The top three reasons for implementing T-CPR in the routine T-CPR group were that they had received T-CPR training (67.08%), believed that T-CPR could improve survival rate (63.59%), and had standard T-CPR process (63.09%). The top three reasons for not implementing T-CPR in the control group were that worrying about bystander compliance (42.04%), worrying about the quality of bystander cardiopulmonary resuscitation (CPR) (38.28%), and worrying about medical dispute (36.14%). Conclusions:The awareness and implementation of T-CPR among emergency medical service staffs need to be improved. The implementation of T-CPR depend on telephone dispatchers with clinical medicine background, clear T-CPR policy, standardized operation procedure, and professional assistant tools. To improve the public's awareness of cardiac arrest and cardiopulmonary resuscitation, and to improve the supporting legal system are also conducive to the implementation of T-CPR.

Objective To explore the multiple disciplinary model of emergent extracorporeal membrane oxygenation (ECMO) for cardiac arrest (CA) patients.Methods A retrospective investigation was done to analyze the general material,multiple disciplinary corporations,the complication and its treatment of patients who underwent emergent ECMO for non-surgery CA from January 2016 to August 2017.Results Three patients were all men with mean age 45.3 ± 20.3 years.Their mean cardiopulmonary resuscitation duration was 34 ± 10 min,and 2 patients returned to spontaneous circulation,yet hemodynamics instability.2 patients discharged with cerebral performance category 1-2,however the third died.3 cannulation of femoral artery and venous were all operated by cardiac surgery using surgical exposure via open cutdown.Mean duration of CA to ECMO pump-on was 132 ±93 min,while the mean duration of ECMO was 3 858 ± 1 092min.The implementation and maintenance of ECMO needed collaboration of emergent physicians,cardiovascular medicine and surgeon,anesthetists,nurses and so on.At the same time,incision site oozing blood,platelet counting decreasing,coagulopathy and other complications would occur,which needed interventional vascular surgeon and blood bank to participate in.Conclusions Emergent ECMO for CA patients need corporations of prehospital emergent medical system,emergent physicians,cardiovascular physicians and surgeons,anesthetists,perfusionists,blood bank and so on.Establishing coordination and cooperation model of multiple disciplinary quick response team with emergency department as the guide is the important guarantee for emergent department developing emergent extracorporeal resuscitation.