Objective:To investigate the efficacy of modified urethral dilatation in the treatment of female bladder neck obstruction.Methods:The clinical data of 33 female patients with bladder neck obstruction who underwent modified urethral dilatation in the Third People's Hospital of Qingdao from March 2015 to March 2020 were retrospectively analyzed. Before treatment, physical examination, routine urine examination, International Prostate Symptom Score, ultrasound examination, urodynamic examination and cystourethroscopy were performed to confirm the diagnosis. All patients were treated with α-blocker for more than 3 months, but obvious effect was not obtained. Under local anesthesia, they underwent modified urethral dilatation. After 3 months of treatment, International Prostate Symptom Score and urodynamic examination were performed to determine residual urine volume, the maximum urinary flow rate, and detrusor pressure at the maximum urinary flow rate. The curative effects of modified urethral dilatation were evaluated.Results:After modified urethral dilatation, dysuria was obviously alleviated in 25 patients. Eight patients who had no obvious improvement in dysuria were scheduled to undergo transurethral bladder neck incision. International Prostate Symptom Score after treatment was significantly lower than that before treatment [(15.18 ± 6.19) vs. (24.86 ± 7.26), t = 3.782, P < 0.001). Residual urine volume after treatment was significantly smaller than that before treatment [(53.69 ± 48.35) mL vs. (181.45 ± 92.15) mL, t = 15.328, P < 0.001]. The maximum urinary flow rate after treatment was significantly higher than that before treatment [(16.21 ± 4.22) mL/s vs. (7.91 ± 1.69) mL/s], t = 6.358, P < 0.001]. Detrusor pressure at the maximum urinary flow rate after treatment was significantly lower than that before treatment [(27.38 ± 5.13) cmH 2O vs. (57.15 ± 8.43) cmH 2O, t = 9.584, P < 0.001]. Conclusion:Modified urethral dilatation is an effective treatment method of female bladder neck obstruction. It can be used as a supplement for surgical treatment.

At present, Chinese medical field faces with an important problem of how to correctly handle the relationship between medical and scientific research. Academician Li Lianda advocates doctors doing scientific research under the premise of putting the medical work first. He points out that there are many problems in the process of doctors doing scientific research at present such as paying more attention to scientific research than medical care, excessively promoting building scientific research hospital, only paying attention to training scientific talents, research direction be flashy without substance, the medical evaluation system should be improved and so on. Medical, scientific research and teaching are inseparable because improving medical standards depends on scientific research and personnel training. But not all doctors need to take into account of medical treatment, scientific research and teaching in the same degree while not all hospitals need to turn into three-in-one hospital, scientific research hospital or teaching hospital. It must be treated differently according to the actual situation.
Altitude ; Biomedical Research ; education ; manpower ; trends ; Humans ; Physicians ; psychology ; statistics & numerical data

Objective To observe the effect of comprehensive rehabilitation based on motor control on sensory-ataxic acute Guillain-Barre syndrome. Methods A patient with sensory-ataxic acute Guillain-Barre syndrome was treated with kinesitherapy based on motor control,included proprioceptive neuromuscular facilitation, coordination training, functional training, balance training, as well as sensory stimulation on the end of arms and legs, recumbent cross trainer therapy and cycle therapy for 2 months. Results After treatment, the score of International Cooperative Ataxia Rating Scale (ICARS) decreased 36 points, activities of daily living increased 9 points, Berg Balance Scale increased 9 points, and modified Barthel Index increased 50 points. Conclusion The comprehensive rehabilitation based on motor control is effective on this patient, but more cases and systematic curative effect evaluation are needed.

Objective To investigate the therapeutic effect of minimally invasive percutaneous nephrostolithotomy (mPCNL) in treatment of kidney calculi and the influence of renal function.Methods According to the operation method,70 patients with kidney calculi were divided into mPCNL group (38 patients) and percutaneous nephrostolithotomy (PCNL) group (32 patients).The curative effect,serum creatinine (SCr) and blood urea nitrogen (BUN) postoperative 1 month were compared.Results The patients in two groups were successfully for broken calculi.The operation time of stag-horn calculi,retinitis simplex kidney pelvis calculi and kidney calices multiple calculi in PCNL group were significantly shorter than those in mPCNL group [(89.13 ± 13.36) min vs.(112.32 ± 12.41) min,(65.28 ±9.76) min vs.(78.84 ± 12.03) min,(98.97 ± 11.84) min vs.(112.64 ± 10.87) min,P ＜ 0.05].The first stage clearance rate of retinitis simplex kidney pelvis calculi in PCNL group was significantly higher than that in mPCNL group [88.89％(8/9) vs.57.14％(8/14),P ＜ 0.05].But the clearance rate of kidney calices multiple calculi in PCNL group was significantly lower than that in mPCNL group [58.33％(7/12) vs.86.67％(13/15),P＜0.05].The first stage clearance rate of stag-horn calculi in two groups had no significant difference [63.64％(7/11) vs.66.67％ (6/9),P ＞ 0.05].The patients in two groups had no serious complication.The rate of fever after operation in two groups had no significant difference [15.63％ (5/32) vs.10.53％ (4/38),P ＞ 0.05].The level of SCr and BUN in the patients combined with kidney insufficiency in two groups were decreased slightly (P ＞ 0.05).The improvement rate of renal function in two groups had no significant difference (P ＞0.05).Conclusions mPCNL and standard channel PCNL in treatment of kidney calculi can achieve a good first stage clearance rate,and the incidence rate of postoperative complication is lower.mPCNL and standard channel PCNL have no obviously influence on early stage renal function.The operation time of mPCNL is generally longer,but the therapeutic effect of kidney calices multiple calculi is better than standard channel PCNL.

Cyclosporine ; pharmacokinetics ; therapeutic use ; Humans ; Treatment Outcome

Humans ; Male ; Middle Aged ; Polycythemia ; etiology ; Sleep Apnea, Obstructive ; complications

Humans ; Mouth Diseases ; diagnosis ; therapy ; Orthodontics, Corrective

Objective To evaluate the effects of different degrees of acute normovolemic hemodilution (ANH) on intrapulmonary shunting, oxygen delivery and consumption during one-lung ventilation(OLV) in dogs. Methods Twelve healthy mongrel dogs weighing 18-22 kg were anesthetized with Ⅳ pentobarbital sodium 20mg.kg-1, scopolamine 0.3 mg and pancuronium 0.2 mg. kg-1 and intubated with a left-sided Carlen' s tube. Correct positioning of the tube was verified by auscultation and by visual inspection after thoracotomy at the end of the experiment. The dogs were mechanically ventilated with 100% oxygen. PET CO2 was maintained between 4.67-6.00 kPa. ECG and rectal temperature were continuously monitored. An intravenous line was established for infusion of Lacted Ringer solution. SwanGanz catheter was inserted via femoral vein on one side for sampling of mixed venous blood and measurement of cardiac output (CO) by hemodilution technique and pulmonary artery pressure (PAP).Femoral artery on the other side was cannulated for measurement of mean arterial pressure(MAP) and arterial blood sampling. The body temperature was maintained between 35℃-39℃ during the experiment.Four degrees of ANH were achieved by blood withdrawal and replacement with an equal volume of gelofusin step by step: HD1 (Hct 35%), HD2 (Hct 25%), HD3 (15%) and HD4(7%-8%). The volume of blood to be removed was based upon the patients' estimated blood volume [EBV = body weight (kg) ×7% ], the beginning Hct(Hct0) and the target Hct (Hctt) V = EBV × (Hct0-Hctt)/Hctav. During each degree of hemodilution(HD) two lungs were ventilated(TLV) first followed by one-lung ventilation(OLV)Each ventilation condition was maintained for at least 15 min, then hemodynamics was measured and blood gas analysis including blood concentration of lactate of both arterial blood and mixed venous blood was performed, then Qs/Qt, oxygen delivery (DO2) and oxygen consumption(VO2) were calculated. Results With increasing hemodilution, MAP, pulmonary vaseular resistance(PVR), mean pulmonary arterialpressure(MPAP), PO2 and DO2 had a tendency to decrease, While oxygen extraction ratio(ERO2 ), blood lactate and Qs/Qt tended to increase. There were DO2-dependent VO2 and anaerobic metabolism during HD3 and HD4. PVR and MPAP increased significantly when one lung was being ventilated before HD and during HD1 and HD2 . During HD3 and HD4 there was little difference in PVR and MPAP between OLV and TLV. Qs/Qt increased by 74% (HD2), 164% (HD3) and 177% (HD4) during OLV. Conclusions The results show that both ANH and OLV can affect Qs/Qt and oxygenation. The degree of ANH should be limited to Hct 25 % during OLV.consumpation

Objectives To investigate the clinical significance of degree Ⅲ meconium-stained amniotic fluid in term pregnancy.Methods Data of 857 full-term gravidas underwent cesarean section for suspected fetal distress in Peking University First Hospital from October 1,2012 to September 30,2014 were retrospectively analyzed.All patients were divided into three groups according to the diagnosis of suspected fetal distress:meconium-stained amniotic fluid group (Group 1,n=172),fetal heart abnormality group (Group 2,n=623) and meconium-stained amniotic fluid in combination with fetal heart abnormality group (Group 3,n=62).General information and fetal prognosis of the three groups were analyzed.Factors that might affect the prognosis of newborns were analyzed between the infants with or without acidosis,asphyxia or aspiration pneumonia.Analysis of variance,independent-samples t test,Chi-square test and rank-sum test were used as statistical methods.Results There were no significant differences in maternal age,gestational age at delivery,parity,nuchal cord loop(s),pH value of umbilical arterial blood and gender of newborns among the three groups (all P＞0.05).The neonatal Apgar score,neonatal asphyxia rate and rate of admitting into pediatric ward within 24 hours after birth in Group 1 were similar to those of Group 2 and 3 [1 min Apgar score:9.9±0.7 vs 9.8±0.7 and 9.8±0.7,F=0.322;5 min Apgar score:10.0±0.3 vs 10.0±0.2 and 10.0±0.0,F=0.517;neonatal asphyxia rate:1.7％ (3/172) vs 2.1％ (13/623) and 1.6％ (1/62),x2=0.129;rate of admitting into pediatric ward:16.3％ (28/172) vs 14.3％ (89/623) and 11.3％ (7/62),x2-0.978] (all P＞0.05).The incidence of neonatal aspiration pneumonia in Group 1 was higher than that of Group 2 and 3 [4.7％ (8/172) vs 3.2％ (2/62) and 1.0％ (6/623)],but the differences had no statistical significance (F=10.680,P=0.050).Conclusions Both degree Ⅲ meconium-stained amniotic fluid and abnormal fetal heart rate have the same indicating significance and should be treated actively to lower the risk of poor prognosis of the newborns.