Objective To study the effect of finasteride on preventing prostate hyperplasia with acute urinary retention.Methods Totally 626 patients with benign prostatic hyperplasia (BPH) were randomly divided into treatment group (316 cases) and control group (310 cases),followed up for 3 years.The incidence of acute urinary retention and prostate volume changes were analyzed.Results There were 3 cases of acute urinary retention in treatment group (1.0 ％),9 cases in control group (2.9％) (x2 ＝5.37,P＜0.05).In treatment group,the average prostate volume was reduced about 23.6％ compared with before taking the medicine,on the contrary,prostate volume was averagely increased 12.3％ in control group.Conclusions Finasteride can reduce the risk of acute urinary retention by narrowing the prostate volume in patients of benign prostatic hyperplasia.

ObjectiveTo study the feasibility,safety and efficacy of laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy for adult congenital choledochal cyst.MethodA retrospective study was conducted on 7 adult patients with congenital choledochal cyst who received total laparoscopic cyst excision and Roux-en-y hepaticojejunostomy from May 2008 to February 2011 in the Department of General Surgery of Shengjing Hospital,China Medical University.ResultsAll the laparoscopic surgery was successful.The mean operation time was 210 minutes.The average intraoperative blood loss was 80 ml.All patients were out of bed within the first 24 h after surgery.The mean time to first flatus/bowel motion was 2.4 days.Except 1 patient who had small amount of bile leakage,all patients recovered smoothly without any major postoperative complications.The average hospital stay was 8.1 days.No patients suffered from abdominal pain,fever or jaundice during follow-up from 3 to 30 months.ConclusionTotal laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy was a safe,efficacious,and minimally invasive procedure.

OBJECTIVETo observe the clinical efficacy of BO's abdominal acupuncture for obese type-2 diabetes mellitus (T2DM).

METHODSSixty patients of obese T2DM were randomly divided into an acupuncture group and a medication group, 30 cases in each one. Patients in the medication group were treated with basic treatment combined with oral administration of regular antidiabetics, three weeks as one session. Patients in the acupuncture group, based on the medication group, were treated with abdominal acupuncture at Yinqiguiyuan [Zhongwan (CV 12), Xiawan (CV 10), Qihai (CV 6), Guanguan (CV 4)], Fusiguan [Huaroumen (ST 24), Wailing (TE 5)], Tianshu (ST 25), Daheng (SP 15), Qixue (KI 13), etc.; the treatment was given three times per week, 3 weeks as one session. The systolic blood pressure (SBP), diastolic blood pressure (DBP), body weight, waist circumference (WC), hip circumference, body mass index (BI) were observed before and after treatment in the two groups, and fasting plasma glucose (FPG), fasting insulin (FINS), 2-hours postprandial blood glucose by oral glucose tolerance test (OGTT) and insulin, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), HOMA-IR of insulin resistance index were calculated and adverge events were recorded.

RESULTSCompared before the treatment, SBP, WC, body weight, BMI, FPG, OG-TT2hBG, FINS, GTT2h insulin, HOMA-IR, TC and LDL-C in the acupuncture group were all significantly reduced (all P <0. 05), while FPG, OGTT2H insulin and TG were increased in the medication group (all P<0. 05)'. The differences of reducing SBP, WC, FPG, OGTT2H insulin, HOMA-IR, TC, TG and LDL-C were statistically significant between the two groups (all P<0. 05). The total effective rate was 93. 3% (28/30) in the acupuncture group, which was significantly superior to 23. 3% (7/30) in the medication group (P<0. 01).

CONCLUSIONBO's abdominal acupuncture has obvious clinical efficacy for obese type-2 diabetes mellitus, featuring in lowering blood pressure, reducing weight, decreasing blood glucose, im- proving insulin resistance and lowering lipid, which has no adverse effects and is worthy of clinical popularization and application.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Blood Glucose ; metabolism ; Body Mass Index ; Body Weight ; Cholesterol ; blood ; Diabetes Mellitus, Type 2 ; metabolism ; physiopathology ; therapy ; Female ; Humans ; Insulin ; blood ; metabolism ; Lipoproteins, LDL ; blood ; metabolism ; Male ; Middle Aged ; Triglycerides ; blood ; Waist Circumference

Objective To analyze the common and individual training needs of palliative care among nurses in different level hospitals. Methods The self-designed questionnaire about training needs of palliative care was used to investigate 340 nurses in different level hospitals. The data were analyzed by Ridit analysis method. Results There were 24 important items and 26 unimportant items in the common training needs. Regarding the individual training needs,the concept of palliative care,basic nursing care and bereavement support were preferred by the primary-level hospital nurzes,while the principles of palliative care,basic nursing care and pain management in secondary-level hospital nurses,radiotherapy and chemotherapy care and the ethical and moral problems in palliative care in third-level hospital nurses. Conclusion Different level hospital nurs-es have beth common and individual needs in the training contents of palliative care. Ridit analysis can distinguish the differ-ences and provide reference for the training.

ObjectiveThrough the examination of Clostridium difficile (Cd) in the stool of inflammatory bowel disease (IBD) patients to investigate its infection status in IBD patients and the relationship with IBD.MethodsFrom December 2009 to January 2011,a total of 130 diagnosed IBD patients were collected in the Department of Gastroenterology,Ruijin Hospital,Shanghai Jiaotong University School of medicine,including 60 ulcerative colitis (UC) patients and 70 Crohn's disease (CD) patients.At same time.60 irritable bowel syndrome patients and 60 healthy volunteers were collected as control.Stool samples were tested by PCR and Cd toxin A/B test kit (CDTK).SPSS statistical software was used for statistical analysis.ResultsIn 130 enrolled IBD patients,16 cases (12.3％) were Cd infected,of which 10 were UC cases (16.7％) and 6 were CD cases (8.6％).No Cd infection was found positive in control group (x2 =15.779,P=0.000).The infection rate of Cd in the patients of active stage was higher than that in the patients of inactive stage (x2 =10.092,P=0.001).The infection rate of coion-type CD patients was 4/14,which was significantly higher than those of other types CD patients (x2 =13.125,P=0.001).The infection rate of Cd was 4.5％ in mild UC patients,14.3％ in moderate and 6/17 in severe (x2 =6.667,P=0.037) ; the infection rate were 0％ in mild CD patients,4.2％ in moderate and 5/16 in severe.The infection rate increased along with the increase of The disease severity (x2 =13.907,P=0.000).There was no significant difference in the infection rate of Cd between broad-spectrum antibiotics used and not used patients (x2 =1.414,P =0.378), or between patients with broad-spectrum antibioticsused aloneand combinedwith immunosuppressant (x2 =0.330,P=0.962).ConclusionsThere was certain infection rate of Cd in IBD patients,especially the patients in active stage. The infection rate increased along with the increase of the IBD severity.

Education of medical morality is an important part of medical education and must be through the whole career life of medical workers.Now our society is in the period of transition,but education of medial morality fails to get enough attention.Based on the present situation,the paper first makes a systematic exposition of the importance,intension,element and process of the reception of medical morality education of medical workers,then points out the rule of this reception and the approach to realize the validity of medical morality education.

Objective To evaluate the clinical efficacy of Memotherm TM stent,a type of metallic stent in the management of secondary ureteropelvic junction obstruction. Methods From October 1995 to June 2001,13 cases (10 males and 3 females,mean age of 41 years) of secondary ureteropelvic junction obstruction underwent the Memotherm TM stenting.They were all followed up for an average of 26 months by B ultrasound,IVU,radionuclide renography and ureteroscopy. Results Of the 13 case,8 were cured,and 3 achieved improvement,while 2 cases failed.The main complications of endoprosthetic fibrotic stricture occurred in 5 cases.The forceps or YAG laser through ureteroscopy was used to remove the endoprosthetic fibrotic tissues. Conclusions Memotherm TM stent is mostly effective in the treatment of patients with secondary ureteropelvic junction obstruction,especially for patients who has undergone multiple operations or those are ineligible for open surgery.This procedure can significantly reduce the recurrence of ureterostenosis.

Objective To summarize the causes of failed drainage of double J ureteral stents following ureteroscopy. Methods From June 2000 to March 2003,the double J ureteral stents were placed for 3972 patients (2184 males and 1788 females)following ureteroscopy.The stents were placed through retrograde approach in 3138 cases,through antegrade approach in 1497 cases.The patients were followed up until the ureteral stents were retrieved. Results Of the 4635 cases,failed drainage of double J ureteral stent was found in 115 cases (2.48%).The main causes were severe extra luminal obstruction,serious steinstrasse,severe ureteral stricture and overperiod placement of ureteral stents. Conclusions Correctly identifying the indications for ureteroscopy and the placement of double J ureteral stents as well as close follow up are the keys to reduce the failure rate of drainage of double J ureteral stents following ureteroscopy.

0.05.GFA protein was also detected in skeletal muscle of neonatal and adult mouse by Western blot.The results indicate that the mucsle of adult mouse has the potential to differentiate into glial cells.

Nitric oxide, an intracellular messenger molecule linked to activation of N Methyl D aspartate(NMDA) receptor, plays a role in morphine tolerance and dependence. Nitric Oxide Synthase (NOS) inhibitors attenuate or block morphine actions. NO/NOS system has an effect on morphine induced place preference. Actions of NO/NOS system are involved in the activation of opioid receptors. The effect of NO/NOS system on the expression of morphine withdrawal symptoms may be partially mediated by noradrenergic neuron system. Thus reviews on interactions between NO/NOS system and opioid system are very important towards applications of opioid analgesic as well as treatment against opioid tolerance and withdrawal.