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.

Recombinase polymerase amplification (RPA) is a novel isothermal DNA amplification technology first re-ported in 2006 by Piepenburg et al.This technology has been shown to typically work at temperatures ranging from 25 to 43℃and can detect products within 5-20 min.RPA technology requires little instrumentation for the nucleic acid amplifi-cation reaction and can be performed not only in PCR tubes , but also in simple devices′such as paper .Combined with probe-based detection methods or lateral flow dipstick assay , it can perform quantitative or visual detection respectively . RPA is a technology that is potentially ideal for point-of-care diagnosis and disease prevention and control ,characterized by high sensitivity, high efficiency, high specificity and user-friendliness.This paper introduces the advantages and develop-ment of RPA technology in reaction conditions and product detection ,summarizes the current applications of this technolo-gy,and predicts the trend of application of RPA technology in point-of-care diagnosis and disease prevention and control .

Objective To investigate the clinical efficacy of laparoscopic splenectomy combined with pericardial devascularization.Methods The retrospective cross-sectional descriptive study was adopted.The clinical data of 64 patients who underwent laparoscopic splenectomy combined with pericardial devascularization at the Second Affiliated Hospital of Kunming Medical University from April 2012 to June 2015 were collected.Observed indexes included (1) treatment outcomes,including surgical procedures,operation time,volume of intraoperative blood loss,time of postoperative enteral recovery,time of postoperative drainage tube removal,duration of postoperative hospital stay,occurrence of complications,(2) follow-up situation.The follow-up using reexaminations of blood routine,liver function,coagulation function,gastroscopy and color Doppler ultrasonography of portal vein was performed regularly at postoperative month 1,2,3,6,12,24 until reemergence of gastrointestinal hemorrhage.The final deadline was death of patients and performance of liver transplantation.Measurement data with normal distribution were presented as-x ± s.Results (1) Treatment outcomes:of 64 patients,62 underwent total laparoscopic splenectomy combined with pericardial devascularization successfully.One patient was transffered to hand-assisted laparoscopic splenectomy combined with pericardial devascularization due to uncontrollable hemorrhage.One patient received laparoscopic cholecystectomy firstly with volume of blood loss of about 1 500 mL and terminated surgery after infusion of suspension red blood cells of 6 U and plasma of 900 mL,and underwent laparoscopic splenectomy combined with pericardial devascularization again next week.No postoperative hemorrhage,pancreatic leakage or death occurred during the perioperative period.The operation time,volume of intraoperative blood loss,time of postoperative enteral recovery,time of postoperative drainage tube removal and duration of postoperative hospital stay were (146 ± 33) minutes,(214 ± 31) mL,(24 ± 4) hours,7 days and (14 ± 6) days,respectively.Nine patients had postoperative pleural effusion and recovered after thoracic drainage and thoracentesis.(2) Follow-up situation:All the 64 patients were followed up for an average time of 19.7 months (range,3.0-23.0 months).Reexamination of gastroscopy showed improvement of varicosed veins of lower esophagus and fundus of stomach.During the postoperative 3 months,4 patients had portal vein thrombosis with level of PLT ＞ 700 × 109/L.For patients with D-Dimer ＞ 5,low molecular weight heparin of 0.4 U was injected subcutaneously until D-Dimer ＜ 2.Three patients were loss to follow-up at postoperative month 6 without upper gastrointestinal hemorrhage,hepatic encephalopathy or liver failure.Conclusion Laparoscopic splenectomy combined with pericardial devascularization is safe and effective for portal hypertension,and rigorous perioperative management offers guarantee for surgical safety.

Objective To explore the microsurgical treatment of the fourth ventricular tumors. Methods A total of 29 cases of the fourth ventricular tumors were given microsurgical treatment from January 2000 to June 2003 in this hospital. In 5 cases the tumor was located close to the cortex with the superior vermis involvement and the microsurgical operation was performed through the cerebellar vermis. The remaining 24 cases underwent microsurgical resection of tumor through the cerebellomedullary fissure approach. Results A total resection was achieved in 23 cases, and a subtotal resection in 6 cases. Postoperative complications included 2 cases of hemorrhage of the upper digestive tract, 1 case of mutism, 1 case of hematoma of the fourth ventricular, 1 case of epidural hematoma remote from surgical site, and 1 case of irregular breath. Follow-up surveys in 19 cases for 3~12 months (mean, 5.5 months) revealed no tumor recurrence. Conclusions Preoperative proper differentiating characters of tumors, clarifying the position of tumors' basal part, selecting appropriate surgical approach, and understanding microanatomy of the fourth ventricular are the key to successfully complete the procedure.

Objective To study the expression and significance of galanin (GLA) in the prostate carcinoma (PCa).Methods The samples from 50 patients with benign prostatic hyperplasia (BPH) and 50 patients with PCa and 30 PCa patients with bone metastasis were examined by immunohistochemical staining.Results The positive rates of GLA expression in BPH,PCa,and PCa with bone metastasis were 18 ％ (9/50),68 ％ (34/50),and 80 ％ (24/30),respectively,and there were statistically significant differences between PCa patients,PCa patients with bone metastasis and BPH patients (x2 =25.5,29.74,both P ＜ 0.01),but there was no significant difference between PCa patients and PCa patients with bone metastasis (x2 =1.35,P ＞ 0.05).Conclusion GLA has higher expression in prostatic cancer cells,it might be an important indicators for differentiating prostate cancer from benign prostatic hyperplasia and predicting the prognosis of prostate carcinoma.

The widely application of the radio knife alleviates the patient's pain and improve the medical quality.The radio knife is high frequency power equipment based on the theory that electricity concentrates on the skin.It can directly cut the tissue,homeostasis and cauterize.The safety requirement of this equipment is very strict because unsafe operation will burn the tissue,cause temporal unaware hurt and even endanger the patient's life.If the safety support system is imperfect,disastrous loss or medical conflict will be caused.Users must be cautious in using and familiar with the safety and protection of the radio knife.[Chinese Medical Equipment Journal,2008,29(2):96-98,104]

Objective To evaluate the usefulness of diffusion-weighted imaging(DWI) in the diagnosis and differential diagnosis of gallbladder wall thickening diseases.Methods 42 patients with gallbladder wall thickening (16 patients with carcinoma and 26 patients with benign lesion) were included in this study.All patients performed conventional MRI and DWI.The diagnostic performances of three methods (conventional MRI,visual assessment of color fusion image from DWI and T2WI,and ADC measurement) were evaluated by two radiologists.Results The area under the receiver operating characteristic curve were 0.570,0.849,0.901 for conventional MRI,visual assessment and ADC measurement respectively.The accuracy,sensitivity and specificity were 59.5%,62.5%,57.7% for conventional MRI,85.7%,81.2%,88.5% for visual assessment of color fusion image,and 83.3%,80.0%,85.2% for ADC measurement,respectivily.The mean ADC value of gallbladder cacinoma[(1.15±0.35)×10-3mm2/s]was significantly less than that of gallbladder benign lesion [(1.99±0.61)×10-3mm2/s](P<0.01).Conclusion The DWI(visual assessment of color fusion image and ADC measurement)might be a useful tool for diagnosis and differential diagnosis of the gallbladder wall thickening diseases.

ction of immune tolerance of T cells to allergens.

Objective To investigate the fluid resuscitation strategies to craniocerebral injury patients combined with multiple trauma.Methods This retrospective review was made on 124 patients with combined craniocerebal injury (GCS 3-12 points) plus multiple trauma.Based on the fluid resuscitation strategies,63 patients were treated with aggressive fluid resuscitation (AFR),and 61 with limited fluid resuscitation (LFR).A restrictive rehydration principle was performed with intensive hemodynamic monitoring:mean arterial pressure was kept between 70-80 mmHg for 48 hours and central venous pressure between 6-8 cmH2O for 48 hours in LFR group; mean arterial pressure was kept in basic level and central venous pressure between 8-12 cmH2O in AFR group.No significant differences were shown in the rest of treatments.Parameters were compared between groups such as blood pressure,shock index,coagulation function,imaging data,GCS,and GOS at 6 months postinjury.Results Between-group differences were insignificant with regard to mean arterial pressure (MAP),shock indices,ISS,trauma severity indices (TSI),and GCS (P ＞0.05).Blood pressure fluctuation in LFR group was (18.5 ±9.9) mmHg vs (29.4 ± 11.1) mmHg in AFR group (P ＜ 0.01).Eight patients developed intracranial hemorrhage progression in LFR group,with 3 being treated with craniotomy.In comparison,19 patients developed intracranial hemmorrhage progression in AFR group,with 10 being treated with craniotomy (P ＜ 0.01).Improvement in coagulation disorders was better in LFR group than in AFR group.On days 7 after admission,GCS in LFR groups was (9.1 ± 3.6) points vs (7.2 ± 2.3) points in AFR group (P ＜0.05).At 6-month follow-up,results were 34 good and 27 poor in LFR group,better than 23 good and 40 poor in AFR group.Conclusion For moderate to severe craniocerebral injury combined with multiple trauma,LFR is effective to treat coagulation disorders and hemorrhagic shock,reduce the probability of delayed intracranial hemorrhage,and further improve the outcome.

Objective To compare the feasibility and safety of laparoscopic Roux-en-Y choledochojejunostomy versus open Roux-en-Y choledochojejunostomy.Methods From October 2011 to June 2013,37 patients underwent laparoscopic Roux-en-Y choledochojejunostomy (observation group) and 42 underwent open Roux-en-Y choledochojejunostomy (control group).We retrospectively compare the two groups in terms of operation time,intraoperative blood loss,length of incision,postoperative hospital stay,postoperative gastrointestinal function recovery time,incision infection rate and the incidence of biliary fistula after surgery.Results In observation group operation time was (275.43 t 12.28) min,higher than that of control group (189.12 ± 19.35) min (P =0.031),intraoperative blood loss was (83.13 ±6.34) ml,incision length (5.76 ±0.7) cm,postoperative recovery time of gastrointestinal tract of (43.33 ±3.15) h,postoperative hospital stay (12.65 ± 2.19) d,were in favor of the observation group which were respectively (180.37 ±9.67) ml,(18.51 ±1.9) cm,(70.45 ±4.97) h and (22.16 ±4.61) d (t =33.17,36.73,33.17,P ＜ 0.05).Postoperative incision infection rate in observation group was 5.4％,lower than the control group (19.07％) (chi-square =22.12,P ＜ 0.05).Between the two groups there was no significant difference in the incidence of biliary fistula.Conclusions Laparoscopic Roux-en-Y hepatojejunostomy is safe,effective,and less traumatic procedure.