Postoperative incontinence is one of the most feared complications of radical prostatectomy with a major impact on patients’ quality of life. There are several ways to treat with the incontinence including pelvic lfoor muscle training and medication as the conservative treatment, nerve-sparing approach during the operation and the urethral sling and the artificial urinary sphincter placement as the operative treatment. The aim of this article is to evaluate the treatment stated above to provide some guidance to deal with post-prostatectomy incontinence.

Objective:To compare 4 polyphyllins contents in Paris polyphylla planted under walnut forest in different areas of Yun-nan Yangbi. Methods:Paris polyphylla samples planted under walnut forest were collected in different areas of Yunnan Yangbi, and according to the methods described in Chinese Pharmacopoeia (2015 edition), the contents were determined. Results:Yunnan Yangbi different planted in Paris polyphylla four polyphyllins content of each sample there were significant differences between samples were cultivated in imitation of the wild forest, but the cultivation of varying lengths of time, the growth period of 4 to 5 years in Paris polyphylla four polyphyllins content was significantly higher than that of 3 born in Paris polyphylla. Conclusion: Four kinds of Paris polyphylla saponin content of the samples have significant differences with the Paris polyphylla growth of ecological environment, growth period and the same species living on different populations, the genetic background.

Hedgehog(HH),a vital endodermal signal,plays a critical role in the embryonic development of the GI system.During mammalian embryonic development,deficiency of HH signaling leads to gastrointestinal malformations.Nevertheless,normal presence of HH family is also found in the adult gut,and HH signaling now may be important for homeostasis of the gut in such a case.However,many researches revealed that the HH signal's involved in gastrointestinal carcinogenesis and its role is altered in various tumors due to various mechanisms.This review focused on the progress of HH signal pathway in gastrointestinal tumors.

Adolescent ; Blood Glucose ; analysis ; Female ; Humans ; Kidney Transplantation ; Male ; Sodium ; blood ; Sodium Chloride ; administration & dosage

Objective To evaluate the correlations between arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2) and age in the population of Han nationality aged over 15 years old. Methods Three hundred Chinese Han nationality patients who underwent elective surgery were selected. They were involved in ASA class Ⅰ-Ⅲ, including 162 male and 138 female. Radial artery or dorsalis pedis artery was punctured, performed indwelling catheter, and connected the pressure transducer under local anesthesia. Blood gas analysis was collected before anesthesia. Results The linear regression trend diagram showed that the level of PaO2 had linear negative correlation with age . The calculating formula was PaO2(mmHg) = 101.7- 0.278 × age (years) (1 mmHg = 0.133 kPa, R2=0.903). The level of PaCO2 didn′t change with age, and average was (38.2 ± 2.8) mmHg. Conclusions The level of PaO2 is gradually decreased with age, but the level of PaCO2 isn′t affected by age.

Objective To investigate the therapeutical effect and mechanism of tiotropium bromide in patients with stable phase midrange and severe chronic obstructive pulmonary disease (COPD). Methods Seventy-eight patients with stable phase midrange and severe COPD were selected, and they were divided into observation group (40 cases) and control group (38 cases) according to treatment method. All patients were given conventional treatment. The patients in observation group were given tiotropium bromide, and the patients in control group were given terbutaline according to the needs for 12 weeks. The changes of dyspnea, 6 min walking distance, pulmonary function, leukotrienes C4 (LTC4), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-ɑ) before and after treatment, and drug adverse reaction were observed. Results The dyspnea score after treatment in observation group was significantly lower than that in control group:(2.9±0.5) scores vs. (3.5±0.7) scores, 6 min walking distance in observation group was significantly longer than that in control group: (427.67±70.36) m vs. (365.41±61.42) m, forced expired volume in 1 second (FEV1) and FEV1/forced vital capacity in observation group were significantly higher than those in control group:(1.76±0.89) L vs. (1.29±0.53) L and (67.43±9.52)%vs. (56.32±8.51)%, LTC4, IL-8 and TNF-αlevels in observation group were significantly lower than those in control group: (397.41± 198.57)μg/L vs. (1 181.95±207.54)μg/L, (434.81±176.05) ng/L vs. (823.37±165.43) ng/L and (0.15±0.02) ng/L vs. (0.25 ±0.02) ng/L, there were significant differences ( P<0.01). Pearson correlation analysis result showed that serum LTC4 level was negatively related to FEV 1 (r=-0.578, P=0.024);and the serum IL-8 level was negatively related to FEV1 (r=-0.542, P=0.019). There was no obvious drug adverse reaction in the two groups. Conclusions Tiotropium bromide can significantly improve the clinical manifestations in patients with COPD. Tiotropium bromide may take effects by blocking various inflammatory factors release in the stable phase of COPD.

The United States is one of the pioneers in the world to introduce a heath strategy, making its practice highly significant for other countries. The paper described the four health strategies developed by the US government in succession, including the goals, focused areas and key health indicators of the strategies in different stages. In addition, it analyzed the patterns of evolution and key features of the strategy, offering references for the development and implementation of the "Health China by the Year 2020".

Objective To investigate the effect of sustentaculum tali screw placement on outcomes following open reduction and internal fixation (ORIF) of intraarticular calcaneal fractures.Methods A retrospective analysis was made on 139 patients with intraarticular calcaneal fractures treated by ORIF from April 2008 to January 2012.According to Sanders classification,there were 9 patients with type Ⅱ fractures,87 with type Ⅲ fractures and 43 with type Ⅳ fractures.Fracture reduction followed by placement of calcaneal anatomic plate or anatomic locking plate was performed via calcaneal lateral L-shape incision.All the patients received X-rays and CT scans within postoperative 2 weeks.Placement of screws in sustentaculum tail was detected by CT volume rendering to visualize implants combined with multiplanar reconstruction imaging (MPR).Patients were divided into accurate fixation group (Group A,n =28),marginal fixation group (Group B,n =58),and non-fixation group (Group C,n =53) based on radiological results.Intra-and peri-operative parameters,time to partial weight-bearing,time to full weight-bearing,fracture healing time,and clinical outcome were compared among groups.Functional outcome was assessed using American Orthopedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Scale.Results Postoperative X-rays indicated accurate fixation of sustentaculum tail in 64 patients,marginal fixation in 22,and non-fixation in 53,but CT images manifested accurate fixation in 28 patients,marginal fixation in 58,and non-fixation in 53.Group A had operation duration of (93 ±11) min and intraoperative blood loss of (252 ± 27) ml,longer or higher than those in Group B [(85 ±8) min,(194±16) ml] and Group C [(57±6) min,(136 ±13) ml] (P＜O.05).There was no significant difference in mean hospital stay among the three groups (P ＞ 0.05).Ninety-two patients were followed-up for 12-38 months (mean 18.5 months) and 85 patients completed foot and ankle exercise as planned.Moreover,no significant differences were observed among groups concerning time to partial and full weight-bearing,fracture healing time and AOFAS score at the final follow-up (P ＞ 0.05).Conclusion Sustentaculum tali screw placement has no apparent effect on the short-term outcome of surgical treatment for calcaneal fractures.

Objective To explore the factors associated with delayed defecation in long-term ventilated patients in intensivecare unit (ICU) and their potential effect on prognosis.Methods A prospective observational cohort study was conducted. The patients admitted to general ICU of the Affiliated Hospital of Qingdao University from October 1st in 2013 to September 30th in 2015 who underwent mechanical ventilation (MV) for ≥6 days were enrolled, and they were divided into early defecation group (< 6 days) and late defecation group (≥6 days). At admission, clinical nutritional support were given as usual, and gender, age, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, admission reasons, MV reasons, the usage of morphine and epinephrine/norepinephrine, the highest positive end-expiratory pressure (PEEP), the lowest oxygenation index (PaO2/FiO2) and the lowest systolic blood pressure were collected. Logistic regression analysis was used to analyze the influencing factors of the first defecation time. ICU mortality, the length of ICU stay, central venous catheter (CVC) indwelling time, duration of MV, ICU acquired bacterial infection rate, and the incidence of ventilator associated pneumonia (VAP) were compared between early defecation group and late defecation group. Logisticorgan dysfunction system (LOD) scores and gastric residual volume per day were recorded at the different time of MV.Results Totally 189 patients were enrolled, 39 patients did not satisfied the inclusion criteria and 13 patients gave up treatment or referrals were excluded. Finally 137 patients were enrolled in the analysis, 83 patients in late defecation group and 54 in early defecation group. There were no significant differences in the baseline characteristics such as gender, age, APACHE Ⅱ score, LOD score at 1 day of MV, admission reasons, MV reasons, disgorging and gastric residual volume per day during the first 5 days of MV, enteral nutrition, lactulose treatment in patients with hepatic encephalopathy during the first 5 days of MV, and blood purification treatment between the two groups (allP > 0.05). Compared with the early defecation group, late defecation group had less patients with loose stools or watery stool at first time [15.7% (13/83) vs. 33.3% (18/54)], more patients using morphine and the usage of epinephrine/norepinephrine more than 24 hours [48.2% (40/83) vs. 40.7% (22/54), 42.2%(35/83) vs. 29.6% (16/54)], higher the maximum PEEP level [cmH2O (1 cmH2O = 0.098 kPa): 7.9±3.7 vs. 6.7±3.5], lower the minimal systolic blood pressure [mmHg (1 mmHg = 0.133 kPa): 74.8±28.1 vs. 88.9±30.2] and more severe of hypoxemia [PaO2/FiO2 < 150 mmHg, 54.2% (5/83) vs. 44.4% (24/53)], all of which had significant differences (allP < 0.05). Factors found statistical significances by single factor analysis were enrolled in the multiple regression analysis, which showed that PaO2/FiO2 < 150 mmHg and systolic blood pressure < 90 mmHg were independently associated with a delay in defecation in patients undergoing long-term MV [PaO2/FiO2 < 150 mmHg: adjusted hazard rate: 1.415, 95% confidence interval (95%CI) = 1.061-1.590,P = 0.026; systolic blood pressure 70-89 mmHg:HR = 1.461, 95%CI = 1.164-1.788, P = 0.002; systolic blood pressure ≤ 69 mmHg: adjusted hazard rate= 1.273, 95%CI = 1.010-1.587,P = 0.034). ICU mortality, the length of ICU stay, CVC indwelling time, duration of MV, ICU acquired bacterial infection rate, and the incidence of VAP at 7 days of MV in late defecation group were significantly higher than those of early defecation group [ICU mortality rate: 15.7% (13/83) vs. 7.4% (4/54), the length of ICU stay (day): 17.0 (14.0, 23.0) vs. 15.0 (13.8, 20.0), CVC indwelling time (days): 12.0 (10.0, 14.0) vs. 10.0 (9.0, 11.3), duration of MV (days): 14.0 (10.0, 20.0) vs. 11.0 (9.8, 15.3), ICU acquired bacterial infections rate: 60.2% (50/83) vs. 14.8% (8/54), the incidence of VAP: 32.5% (27/83) vs. 14.8% (8/54); allP < 0.05]. There was no significant difference in LOD score between both groups. The LOD scores at 4 days and 9 days of MV in late defecation group were significantly higher than those of early defecation group (6.41±4.37 vs. 5.21±3.12, 4.33±2.20 vs. 3.50±2.90, bothP < 0.01).Conclusions PaO2/FiO2 < 150 mmHg and systolic blood pressure < 90 mmHg during the first 5 days of MV were independently associated with a delay in defecation in patients undergoing long-term MV. The results suggest that constipation is associated with adverse outcomes in long-term ventilated patients.

Objective To make a comparison between noninvasive blood pressure (NIBP) and invasive blood pressure (IBP). Method Totally 450 patients undergoing selective surgery received radial artery or dorsalispedis artery puncture and catheter under local anesthesia to figure out the difference between NIBP and IBP. Results The systolic blood pressure difference of IBP from different positions and NIBP were as follows:left radial artery group (18.20 ± 0.67, 15.27 ± 0.62) mmHg, right radial artery group (18.54 ± 0.79, 14.68 ± 0.77) mmHg, left foot dorsal artery group (41.98 ± 2.26, 40.54 ± 1.77) mmHg and right foot dorsal artery group (37.57 ± 0.01, 37.93 ± 2.90) mmHg. The noninvasive systolic blood pressure difference between left and right arms was (2.84 ± 0.45) mmHg, the noninvasive diastolic blood pressure difference (3.19 ± 0.34) mmHg, and the noninvasive mean blood pressure difference (2.85 ± 0.35) mmHg. The NIBP of right arm was higher than that of left arm. Conclusions IBP is higher than NIBP, and the invasive artery systolic blood pressure is about 20mmHg higher than noninvasive systolic blood pressure. Meanwhile we confirm that systolic blood pressure gradually rises over 30 years old, and diastolic blood pressure increases while gradually declines after 50.