Objective To compare the outcomes of TOT and TVT procedure treating female intrinsic sphincter deficiency (ISD).Methods From May 2010 to September 2015,42 stress urinary incontinence (SUI) patients whose abdominal leak point pressure was less than 60 cmH2O were enrolled in this study.Thirty-five patients were followed up.The mean age was (56.8 ±10.5) years,with a range of 30-80 years.The mean history was(10.5 ± 9.1)years,with a range of 4 months to 30 years,with 26 (74.3％) of them being postmenopausal,5 (14.3％) having a history of pelvic surgery,and no pelvic organ prolapsed or hormone replacement.All of them were randomly divided into 2 groups to undergo either TVT operation (13 cases) or TOT operation (22 cases).The baseline characteristics of the two groups including age,length of history,urodynamic parameters and scale scores showed no significant difference.The scales including urinary incontinence severity score (UISS),detrusor instability score (DIS),Quality of Life Scale Evaluation (I-QOL),lower urinary tract symptoms affect score (UDI-6) were used.The outcomes between TVT group and TOT group were compared.Result After procedure,patients in TVT group got a lower UISS score than TOT group(17.2 ± 2.2 vs.17.7 ± 3.1),and their severity of urinary incontinence improved significantly (P ＜ 0.05).Patients from TVT group got a lower DIS score than TOT group (12.6 ± 4.2 vs.14.2 ± 3.5),and their detrusor instability symptoms improved more significantly (P ＜ 0.05).Patients from TVT group got a higher I-QOL score than TOT group(17.5 ± 14.5 vs.16.1 ± 13.0),and their quality of life improved more significantly (P ＜ 0.05).Patients from TVT group got a lower UDI-6 score than TOT group (10.1 ± 3.0 vs.11.2 ± 3.4),and their lower urinary tract symptoms improved more significantly (P ＜ 0.05).Conclusion Urinary incontinence of female ISD patients were improved greater by TVT than TOT procedure.

Objective:To compare the effects of rotational night shifts on the micturition patterns of fe-male nurses.Methods:A total of 58 nurses without lower urinary tract symptoms were recruited,who worked in the Peking University People’s Hospital during January and June in 2014.The nurses aged 20 -43 years were divided into two groups,the night-shift group (n =28)and the non-shift group (n =30).The alcohol or coffee intaking were forbidden.In the night-shift group,nurses had worked on rota-tional shifts for at least 6 months.Their average age was (26.75 ±4.11)years.In the non-shift group, nurses took regular day-time work,whose average age was (27.80 ±5.60)years.A voiding diary was kept for 7 consecutive days at the end of 6 months,starting 2 days before their night duties until 4 days after completion of their night duties.For comparison,the non-shift group with regular shifts completed a 7-day voiding diary.In the 7-day recording voiding diary,the nurses were required to have the normal in-take of liquid about 1 500 -2 000 mL/d.The frequency volume charts of nocturia,the 8-hour interval urine production and frequency were compared between the two groups.Results:Nocturia frequency was increased in the night-shift group [0.5 (0 -2.4)]compared with the non-shift group [0 (0 -2),P =0.02].The volume of nocturia was increased in the night-shift group [125 mL (0 -660 mL)]compared with the non-shift group [0 mL (0 -340 mL),P <0.01].The 8-hour interval indices showed that urine production changed with shift (P <0.01).In the consecutive 7 days,the nocturnal volume of the night-shift group increased on the day after night shift.When the night-shift nurses returned to daytime duty, the volume of urine decreased but nocturnal urine production remained high,and the frequency of noctu-ria also increased significantly (P <0.05).Compared with the 8-hour interval indices,the night-shift group’s voiding volume [(542.35 ±204.66)mL]and voiding frequency (2.24 ±0.69)were more than those of the non-shift group at the afternoon time (from 2 pm to 10 pm).During the 8 h interval night time (from 10 pm to 6 am),the volume of nocturia in the night-shift group [(309.74 ±162.74) mL]was more than that in the non-shift group [(199.38 ±153.98)mL,P =0.01];the frequency of nocturia in the night-shift group (1.31 ±0.52)was increased than that in the non-shift group (0.82 ± 0.55,P <0.01).Conclusion:The rotational shifts affect the micturition patterns of nurses who go through the night shift work,which increases the volume and frequency of the nocturia.

Objective:To investigate the impact of preoperative urodynamic study on the diagnosis and treatment for female patients with clinical diagnosis of stress urinary incontinence by studying their diag-nosis and treatment database,and to assess its clinical significance of urodynamic study.Methods:From April 2011 to December 2015,196 female patients diagnosed clinically with stress urinary incontinence underwent preoperative urodynamics study,after excluding pelvic organ prolapse.The preoperative uro-dynamic data of these 196 cases were analyzed and the clinical significance of urodynamics on differential diagnosis and treatment for the female patients with stress urinary incontinence was evaluated.Results:In this study,23 cases (11.73%)changed or amended their diagnoses by the urodynamic study,which were inconsistent with the previous clinical diagnoses concluded by the symptoms,physical examinations, and lab tests.A total of 10 cases underwent a different surgery or conservative treatment instead of the original treatment according to urodynamic study.Of them,3 were diagnosed as detrusor overactive and undertook conservative treatment;3 were diagnosed as bladder outlet obstruction plus stress urinary in-continence and were undertaken the transurethral resection of the bladder neck (TURBN)plus tension free vaginal tape (TVT);2 were diagnosed as bladder outlet obstruction plus stress urinary incontinence and were undertaken TURBN alone;1 was diagnosed as bladder outlet obstruction plus stress urinary in-continence and was undertaken TURBN plus tension free vaginal tape obturator (TOT);1 was found no abnormal bladder function turned out to be interstitial cystitis and went for a bladder instillation of drug. The changed treatments avoided the risk of dysuria or residual urine increased after operation due to inap-propriate surgical methods.Conclusion:In order to make a correct diagnosis and suitable treatment for female patients with stress urinary incontinences,the preoperative urodynamic study is necessary besides detailed medical history,physical examination,and laboratory tests.With the help of the urodynamic study,the concomitant diseases of patients with stress urinary incontinence may be detected,the individualized treatment regimen can be developed,and more importantly,the inappropriate surgical de-cision can be avoided.

Medical college of Xi`an Jiaotong university offered the functional experiment course in 1997. The courseincludes the basic knowledge of medical scientific research, the experimental design and the implementation of theexperiment, totally 24 hours. The course determines the key role of students in teaching, cultivates their ability to studyindependently and raises their comprehensive ability. The course assessment shows a good result.[

Objective:To investigate the use of antibacterial agents for emergency patients with acute upper respiratory infections in tertiary hospitals in Beijing .Methods:We used the medical claim data for urban workers in 10 tertiary hospitals in Beijing from Oct .2010 to Sep.2012.Medical records of emer-gency patients with acute upper respiratory tract infections had been selected as the study sample .The proportions of antibacterial prescriptions and categories of antibacterial drugs were described and ana -lyzed.Results:This study included 135 979 visitors (male:42.7%;mean age:43.6 ±16.2 years).The average antibacterial prescription rate was 71.2% (95%CI 71.0%-71.5%), of which the single kind use was 80.0%(95%CI 79.7%-80.2%).Among acute upper respiratory tract infections , the antibacte-rial prescription rate for acute tonsillitis visits was highest (85.1%, 95%CI 84.5%-85.6%), followed by acute laryngitis and bronchitis (81.69%, 95%CI 80.4%-82.8%), acute pharyngitis (81.4%, 95%CI 77.7% -85.0%), acute sinusitis (77.0%, 95%CI 74.6% -79.4%), acute nasopharyngitis (74.3%, 95%CI 73.7%-75.0%), and common cold (67.6%, 95%CI 67.3%-67.9%).Compared with the female group, the antibacterial prescription rate for the male was higher (73.2%, 95%CI 72.8%-73.6%vs.69.7%, 95%CI 69.4%-70.0%).Compared with the <60 years age cases, the anti-bacterial prescription rate for the ≥60 years cases was higher (72.1%, 95%CI 71.8%-72.3% vs. 66 .8%, 95%CI 66 .2%-67 .5%) .In the visitors who used antibacterial drugs , the average percentage of injection use was 50.6%(95%CI 50.3%-50.9%).The top antibacterial drugs in the list of varie-ties were the second generation cephalosporins (28.4%) , followed by the third generation cephalosporins (21.7%), fluoroquinolones (21.0%) and macrolides (17.6%).Conclusion: The antibacterial pre-scription rate for acute upper respiratory tract infections in the general hospitals in Beijing is high , and the second generation cephalosporins , third generation cephalosporins , fluoroquinolones and macrolides take the lead in the total antibacterial drugs .

Objective To assess the long-term outcome of transurethral resection of the prostate (TURP) in men with different maximum detrusor pressure (Pdet.max).Methods 113 neurologically intact men diagnosed with BPH and undergone surgical intervention in our department were enrolled between Feb.2009 and May 2012.All patients had completed the International Prostate Symptom Score (IPSS) and quality-of-life (QOL) questionnaires and had undergone a full urodynamic analysis before surgery.The outcomes were assessed at 24 months postoperatively using the IPSS score,QOL score,and maximum urinary flow rate (Qmax).Results After 24 months follow-up,3 cases in the poor symptom improvement group could not void.The average Pdet.max of these three patients was (15.7±5.1) cmH2O,which was statistically significantly lower than that of the other three groups [(102.7±39.3),(95.9±42.8),(77.0±27.4) cmH2O] (P＜0.05).Nine cases in the poor functional improvement group whose average Pdet.was (32.5± 16.6) cmH2O,which was statistically significantly lower than that of the other three groups [(115.2±36.3),(87.5±28.7),(75.5±46.9) cmH2O] (P＜0.05).Conclusions Urodynamic analysis plays an important role in judging the efficacy of TURP.Patients with a Pdet.max less than 32.5 cmH2O may not have an objectively successful result from surgery treatment.

Objective To evaluate the reliability and validity of the Chinese version of the King's Health Questionnaire (KHQ) in patients with overactive bladder(OAB).Methods The original English KHQ was translated into Chinese and linguistically validated following the Cross-cultural adaptation of health-related quality of life measures. Patients recruited randomly from urology clinics were scheduled for two visits with 2 weeks apart, and they were surveyed through the Chinese version of the KHQ. Internal consistency reliability was assessed by Cronbach's α test;Test-retest reliability was examined among stable patients using Intraclass correlation coefficient (ICC) and Spearman's rank correlation statistical analyses. Content validity was estimated by Spearman's rank correlation statistical analyses. A factor analysis was conducted to validate the underlying factor structure of the Chinese version of the KHQ. Results A total of 48 OAB patients who met the criteria participated the study, and 40 patients (7 men, 33 women) completed the questionnaires twice. All the subscales and domains of the KHQ showed high levels of internal consistency (Cronbach's a: 0.718-0. 924) , moderate to excellent test-retest reliability (ICC:0.551-0.923,P<0.01) and acceptable construct validity. The content validity was moderate to excellent except for the Social Limitations domain. Conclusion Psychometric testing supports the reliability and validity of the Chinese version of the KHQ as an OAB-specific measure of HR QOL.

Objective To evaluate the prevalence, associated risk factors and the impact on health related quality of life of overactive bladder (OAB) syndrome in Beijing adult women. Methods In the Community-based, cross-sectional study, 2973 women aged over 18 years who lived in urban and suburban communities respectively in Beijing were interviewed through Voiding Function Questionnaire, using a stratified system sampling approach. The women meeting the diagnostic criteria of OAB using the International Continence Society (ICS) definition were further interviewed through King's health questionnaire(KHQ) to estimate the impact of OAB on health related quality of life in Beijing adult women. Results A total of 2379(80.0%) women with complete data were included in this study. The overall prevalence of OAB was 4.7% (112/2379)and demonstrated an significant increasing with advancing age (P＜0.01). The prevalence of OAB was 2.0% in urban and 8. 1 % in suburban. In multiple logistic models, age, BMI, region of residence and anxiety level were associated risk factors for OAB. The result of King's health questionnaire showed the symptoms of OAB affect general health perception and sleep and energy severely. Conclusions The prevalence of OAB in Bei-jing adult women is 4.7%, lower than that of most reports in Occidental women, increases with advancing age, higher BMI and higher anxiety level, and is higher in suburban than in urban. The symptoms of OAB have a detrimental effect on quality of life.

Objective To compare the outcomes between interstitial cystitis/painful bladder syndrome (IC/PBS) patients treated with four-drug combination (heparin,lidocaine,sodium bicarbonate,gentamicin) and sodium hyaluronate intravesical instillation.Methods There were 23 IC/PBS patients from Jan.1,2011 to Mar.1,2013.Ten patients (group A) received four-drug combination (heparin 40 000 U,'gentamicin 160 000 U,sodium bicarbonate 1％,lidocaine 0.4％) instillation treatment.Thirteen patients received instillation of sodium hyaluronate (40 mg/50 ml) therapy (group B).In group B,intravesical instillations were performed weekly in the first 6-8 weeks,and monthly until one year.Patients in group A received intravesical instillation twice a week in the first 6-8 weeks and twice a month for 10 months.All the patients were instructed to retain the instillation volume for at least one hour.Clinical symptoms (24 h frequency of urination,maximal micturition volume),O'Leary-Sant symptom and problem index were assessed at baseline and 1,6 and 12 months after treatment.The 2 therapies were compared within curative effects and side effects.Results Twenty-two of the 23 patients were followed up to 12 months.Patients in group A had no adverse events reported.One case of group B dropped out from treatment for recurrent urinary tract infection,and the other two cases felt painful in bladder area during instillation.There was no significant difference in initial scores between the 2 groups (P＞0.05).At 1,6,12 months after intravesical instillation,interstitial cystitis symptom index,interstitial cystitis problem index,24 h frequency of urination,the maximum bladder capacity were improved in both groups.All indicators in group A and B were improved significantly after treatment compared with pretreatment (P ＜ 0.05).≥ 25％ decrease of interstitial cystitis symptom index or ≥25％ decrease of 24 h frequency of urination were defined as remission.Remission rates of the 2 groups at each time point were:1 month after treatment (100％ versus 100％,P=1.000),6 months after treatment (80％ versus 83％,P=1.000),1 year after treatment (70％ versus 75％,P=1.000).There were no significant differences between the 2 groups in all time points for the outcomes (P ＞ 0.05).Conclusion The four-drug combination intravesical instillation could achieve a similar effect with hyaluronic acid therapy in patients with IC/PBS.

Objective:To investigate age related changes in urodynamic parameters of women with uri-nary incontinence.Methods:From May 2008 to October 2015,a total of 214 patients diagnosed with urinary incontinence in Peking University People’s Hospital was involved in this study.Average age was (56.97 ±10.68)years,ranging from 30 to 82 years,and average history was (8.44 ±8.85)years, ranging from one month to 50 years.Urodynamic examinations of each patient were taken before operation routinely in Department of Urology,Peking University People’s Hospital.The urodynamic study was composed of non-invasive and invasive procedures.Analysis included maximal flow rate (Qmax ),average flow rate,time to Qmax ,voiding time,detrusor pressure at Qmax ,maximal detrusor pressure,voided volume,post-void residual urine volume (PVR),the total capacity of bladder,first-,strong-,and urge-desire to void,cough leak point pressure (CLPP),and Valsalva leak point pressure (VLPP).Patients were divided into four groups according to age,Kolmogorov-Smirnov test and one-way ANOVA were used for data analysis.Results:A total of 214 patients were enrolled in this study.The data of Qmax ,average flow rate,voided volume,and total capacity of bladder decreased with statistical significance.The value of residual urine volume and voiding time increased without statistical significance,while the value of maximal detrusor pressure decreased.Conclusion:Urodynamic examination data of females with urinary incontinence changes along with the elapse of age,which was mainly observed as age ascends,and the changes in urodynamic parameters of women with urinary incontinence suggest that the value of Qmax , average flow rate,voided volume,and total capacity of bladder decreased significantly,while the value of PVR and the voiding time increased and the value of maximal detrusor pressure decreased.